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BMJ Case Rep. 2018 Mar 28;2018. pii: bcr-2017-223048. doi: 10.1136/bcr-2017-223048.

A rare cause of postpartum headache.

Author information

1
Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, UK.
2
Department of Radiology, Princess Royal University Hospital, Orpington, UK.
#
Contributed equally

Abstract

Postpartum women can develop headache, and their assessment requires a thorough and multidisciplinary approach. If the headache is unresponsive to treatment and accompanied by neurological deficit, neuroimaging needs to be undertaken to rule out other life-threatening causes. 1 We present a case of 35-year-old woman with pre-eclampsia and diet-controlled gestational diabetes mellitus, who had normal vaginal delivery at 40 weeks. She had an epidural analgesia for pain relief during labour, but had inadvertent dural puncture during the procedure and developed headache 24 hours after delivery. The headache was managed conservatively and she was discharged home, but was readmitted 8 days later with worsening headache. The headache was postural on admission but became continuous, developed neurological symptoms in the form of ataxic hemiparesis and convulsions. After neuroimaging, she was found to have cerebral venous sinus thrombosis. She was commenced on anticoagulants and anticonvulsants and made a complete recovery.

KEYWORDS:

headache (including Migraines); pregnancy

PMID:
29592984
DOI:
10.1136/bcr-2017-223048
[Indexed for MEDLINE]

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