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Updated: Feb 12, 2026

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A rare cause of postpartum headache
Nayantara Bijral1, Imran Qureshi2, Aisha Hameed1
1Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, UK.
BMJ Case Reports
|March 30, 2018
Summary
Postpartum headaches, especially with neurological symptoms, require urgent neuroimaging. A case highlights cerebral venous sinus thrombosis as a critical diagnosis in women with epidural-related dural puncture.
Area of Science:
- Neurology
- Obstetrics
- Radiology
Background:
- Postpartum headaches are common but require careful assessment.
- Epidural analgesia can lead to inadvertent dural puncture, a known cause of headaches.
Observation:
- A 35-year-old woman with pre-eclampsia experienced a headache post-epidural analgesia with dural puncture.
- Her headache worsened, becoming continuous and accompanied by neurological deficits including ataxic hemiparesis and convulsions.
Findings:
- Neuroimaging revealed cerebral venous sinus thrombosis (CVST).
- The patient was treated with anticoagulants and anticonvulsants.
Implications:
- This case underscores the importance of considering CVST in postpartum women with persistent headaches and neurological signs after dural puncture.
- Prompt diagnosis and management are crucial for favorable outcomes in postpartum CVST.
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