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Published on: January 26, 2024

Postpartum intracranial hemorrhage disguised as preeclampsia

Jason J Tanguay1, Paul J Allegretti

  • 1Department of Emergency Medicine, Midwestern University/Chicago, College of Osteopathic Medicine, Downers Grove, Chicago, IL 60610, USA. jtanguay@gmail.com

The American Journal of Emergency Medicine
|February 15, 2008
PubMed

A 35-year-old woman, gravida 5 para 3, presented to the emergency department 9 days after a cesarean delivery with a new-onset headache, hypertension, and hyperreflexia. Formal urinalysis did not demonstrate proteinuria. Computed tomography of the brain demonstrated bilateral parietal subarachnoid hemorrhages. The patient was subsequently transferred to a tertiary care hospital where she underwent magnetic resonance imaging and computed tomographic angiography that were not suggestive of intracerebral aneurysm, arteriovenous malformation, sinus thrombosis, or angiopathy. The patient was treated with nimodipine and was successfully discharged without any neurologic sequelae or continued hypertension. This case illustrates the potential for presumed postpartum preeclampsia to mask other serious entities, such as intracranial hemorrhage.

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