Clinical and Radiographic Recovery from Postpartum Cerebral Angiopathy with Conservative Management

A 31 year old woman presented with severe frontal headache and blurry vision about 6 days after her normal delivery. Her blood pressure was 193/111 mmHg and her liver and renal function tests and coagulation studies was normal. Her CT Head showed bifrontal subarachnoid hemorrhage (SAH) and MR Angiogram showed characteristic “beaded” appearance of multiple branches of the middle and anterior cerebral arteries bilaterally. The patient was treated with nimodipine and normal saline infusions. Her repeat MRA after one week showed resolution of SAH with normal anterior, middle, and posterior cerebral arteries. The patient was diagnosed with Postpartum cerebral angiopathy.