Pathophysiology of Cerebral Vascular Dysfunction in Pregnancy-Induced Hypertension

PURPOSE OF REVIEW: To review and summarize what is known about cerebrovascular derangements during preeclampsia. RECENT FINDINGS: Preeclampsia is a devastating disorder of pregnancy with no known cure. Little is known about the pathophysiological mechanisms which lead to the symptoms of the disorder, particularly with regard to individual vascular beds such as the cerebral circulation. Studies suggest that the cerebrovascular dysfunction characteristic of the preeclampsia syndrome is characterized by alterations in cerebral blood flow autoregulation and opening of the blood–brain barrier. Mechanistic studies demonstrate that the same circulating factors implicated in the pathophysiology of other vascular beds may be operative in the cerebral circulation as well. However, significant knowledge gaps still exist, highlighting the need for more intense research in this field. SUMMARY: Little is known about cerebrovascular dysfunction during preeclampsia, and detailed mechanistic studies are needed to identify the molecular pathways involved, the interactions thereof, and how those pathways lead to clinical disease.