Unique case of postpartum cerebral angiopathy requiring surgical intervention: Case report and review of literature

Jai Deep Thakur, Prashant Chittiboina, Imad Saeed Khan, Anil Nanda

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Postpartum cerebral angiopathy (PPCA) is a rare form of reversible cerebral vasoconstriction syndrome. A 39-year-old female presented with a 5×6 cm left frontal intracerebral hemorrhage (ICH) and following an emergent neurosurgical evacuation of ICH, she developed a contralateral ICH and intraventricular hemorrhage. Her postoperative course was highlighted by the finding of diffuse bilateral segmental vasospasm on angiography and trans-cranial Doppler, left anterior cerebral artery region infarct and intractable elevated intracranial pressure (ICP). Medical management including osmotic therapy, nimodipine, corticosteroids, and phenytoin was unable to control ICP. Intractable elevated ICP led to evacuation of the right-sided ICH. After 3.5 years, the patient appears to be cognitively intact but continues to have right lower extremity weakness and is wheelchair-bound. Our case suggests that PPCA can rarely manifest as a life-threatening emergency for which neurosurgical intervention may be life-saving.

Original languageEnglish (US)
Pages (from-to)891-894
Number of pages4
JournalNeurology India
Volume59
Issue number6
DOIs
StatePublished - Nov 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Keywords

  • Call Fleming syndrome
  • intracerebral hemorrhage
  • isolated cerebral vasculopathy
  • postpartum cerebral angiopathy
  • reversible cerebral vasoconstriction syndrome

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