Intraventricular hemorrhage in a preeclamptic patient: A late and lethal maternal complication

Abstract

We report a rare case of postpartum intraventricular and intracerebral hemorrhage secondary to eclampsia in a 40-year-old multiparous woman with a history of preeclampsia. The patient underwent a term cesarean section and was discharged with antihypertensive therapy. On the 7th postpartum day, she experienced an eclamptic seizure and was admitted with confusion and elevated blood pressure. Cranial computed tomography revealed multiple parenchymal hematomas in both hemispheres, with the largest measuring 45 mm on the left, and intraventricular hemorrhage. Despite intensive care management, including intubation, mannitol therapy, levetiracetam administration, and external ventricular drainage placement, the patient developed signs of brain death on the 10th postpartum day.

Regular blood pressure monitoring during both antenatal and postnatal follow-up are essential for early detection and management of preeclampsia. Increment in the blood pressure should be considered even after discharge. Additionally, we must keep in mind that preeclampsia can lead to rupture of vessels at a lower blood pressure because of the altered cerebral autoregulation.