Postpartum Ischemic Stroke As the First Manifestation of Late-Onset Preeclampsia: A Case Report

Iliass Benaini1,2, Meriam Azirar1,2, Amine Bensaid1,2

  • 1Intensive Care and Anesthesia Department, Mohammed VI University Hospital, Oujda, MAR.

Cureus
|April 21, 2026
PubMed

Preeclampsia is a severe pregnancy hypertensive disorder characterized by arterial hypertension and multiorgan involvement, most frequently affecting the renal, hepatic, and neurological systems. While its typical manifestations include headaches, visual disturbances, and/or epigastric pain, atypical presentations may occur and may lead to life-threatening complications. We report the case of a 33-year-old multiparous woman who developed sudden left-sided hemiparesis, hemisensory loss, homonymous hemianopia, and rightward conjugate gaze deviation within 24 hours after a cesarean delivery. Blood pressure was 169/103 mmHg. Laboratory tests revealed moderate anemia, elevated LDH, low haptoglobin, and significant proteinuria (4.84 g/24h). Brain MRI demonstrated ischemic lesions in the right fronto-parieto-insular cortico-subcortical regions, consistent with a subacute infarction. The diagnosis of preeclampsia complicated by ischemic stroke was established. The patient was treated with acetylsalicylic acid, levetiracetam, and antihypertensive therapy (methyldopa and nicardipine). She progressively improved and achieved full neurological recovery within six weeks. Prophylaxis with low-dose aspirin and low molecular weight heparin was recommended for future pregnancies. This case highlights the importance of considering preeclampsia as a potential underlying cause of postpartum ischemic stroke. Early recognition of neurological symptoms and timely neuroimaging are critical to prevent severe maternal morbidity.

Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
5
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
9
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
4
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
5
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
7
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
748