Mystery Case: Clinical Reasoning: Recurrent cerebral ischemia during pregnancies

A 29-year-old G6P3023, left-handed woman presented with acute onset left-sided weakness and expressive aphasia. She was in her normal state of health while driving home from work when her mother noted symptom onset. She was taken immediately to the emergency department for further evaluation. On presentation, she was afebrile with blood pressure 136/99 mm Hg, regular heart and respiratory rates, and oxygen saturation 88% on room air. Neurologic examination was notable for left-sided hemiparesis and sensory disturbance. The aphasia had resolved. Emergent head CT did not demonstrate any abnormalities.

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