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G1 aged 25 years at 7weeks of pregnancy presented with sudden onset unconsciousness She was apparently well the previous day and was noticed as unresponsive by the husband. She had history of nonspecific headache for one month prior to the incident. No h/o trauma/ fever/ migraine/ drug intake. She conceived spontaneously after 4 years of married life GCS was E1V2M5 which improved to E3V3M5. vitals were all stable, no hypoglycemia MR Venogram done which revealed acute infarct in bilateral thalamus in midbrain -> s/o involvement of artery of percheron Started on Aspirin and Clopidogrel . She regained consciousness after 48 hours , she was oriented to person but not to time and place. Slurring of speech and vertical gaze palsy and anterograde amnesia was noted. Baseline investigations were all normal including lipid profile,pANCA,c ANCA, LAC,APLA. ENA blot came positive for U1RNP. Echo, transcranial doppler was normal. Aspirin 150 mg hs was continued throughout pregnancy and Clopidogrel 75 mg OD was stopped after three months. She had routine antenatal visits. Anterograde amnesia , increased sleep duration , restricted vertical gaze and gait abnormality are still persistent.She was diagnosed to have GDM at 7 months of gestation and was started on injection Mixtard 6-0-0. Routine ultrasound and doppler was done and was induced in view of GDM and FGR with Foley. She progressed and delivered a Female baby of weight 2.32 kg. Postnataly she was started on Aspirin 75 mg CONCLUSION Multidisciplinary team involving high risk obstetricians, pediatricians and neurologist s are required in managing such high risk cases. Clinical and imaging manifestations helped in arriving the diagnosis Awareness on broad spectrum of stroke manifestations should be kept in mind