Reversible cerebral vasoconstriction syndrome: a severe neurological complication in early puerperium

Reversible cerebral vasoconstriction syndrome (RCVS) is an uncommon entity characterized by transient, segmental vasoconstriction of the cerebral arteries, which may be associated with sudden-onset headache and acute neurological complications. The puerperium represents a recognized risk period for its development. We describe the case of a 29-year-old woman who, in the early puerperium, presented with sudden-onset orthostatic headache, followed by severe acute headache and impaired level of consciousness. Brain computed tomography revealed bilateral intraparenchymal hemorrhages. Angiographic studies demonstrated diffuse cerebral arterial vasospasm, with subsequent normalization of the cerebral vasculature on follow-up. The clinical and radiological manifestations observed in this case are uncommon. This report highlights the importance of considering RCVS in the differential diagnosis of acute neurological complications in the puerperium and of its timely recognition to ensure appropriate management.