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CASE REPORT
A rare cause of postpartum headache
  1. Nayantara Bijral1,
  2. Imran Qureshi2,
  3. Aisha Hameed3
  1. 1 Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, UK
  2. 2 Department of Radiology, Princess Royal University Hospital, Orpington, UK
  3. 3 Obstetrics and Gynaecology, Princess Royal University Hospital, Orpington, UK
  1. Correspondence to Miss Nayantara Bijral, nayantara.bijral1{at}nhs.net

Summary

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.

  • pregnancy
  • headache (including Migraines)
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Footnotes

  • NB, IQ and AH contributed equally.

  • Contributors NB: wrote the manuscript and performed literature search. IQ and AH: participated in literature search and final revision of the manuscript. All authors have approved the final version to be published.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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