Spontaneous postpartum intracranial haemorrhage: A case report

Pregnancy-associated strokes are rare but can have detrimental effects on both mother and baby. A young female patient, 6 days postpartum, suffered a spontaneous intraparenchymal haemorrhage (IPH) and subarachnoid haemorrhage (SAH). The patient exhibited aphasia, right facial droop and right hemiparesis. Serial imaging showed no vascular malformation or other cause of her haemorrhages. Our pregnant patient presented with concurrent IPH and SAH. Given the timing of her stroke and the absence of underlying vascular lesion, it is possible her stroke was a case of IPH and SAH due to reversible cerebral vasoconstriction syndrome (RCVS). More specifically, it may reflect postpartum angiopathy, a subtype of RCVS presenting around 5 days postpartum. Alternatively, this could simply be a subarachnoid extension of a primary IPH.