6th Edition of Neurology World Conference 2026

Abstract

Subarachnoid hemorrhage (SAH) in postpartum is a rare but serious neurological emergency. While most cases result from aneurysmal rupture, non-aneurysmal forms happen in less than one per 100,000 deliveries. Physiological changes during pregnancy and labor—such as hormonal fluctuations, elevated blood pressure, and sudden rises in

intracranial pressure from contractions and the Valsalva maneuver—may increase vascular vulnerability. Although postpartum headache is often attributed to more common conditions like post-dural puncture headache, migraine, or preeclampsia, spontaneous non-aneurysmal SAH can occur in otherwise healthy women. We present the case of a 35-year-old multiparous Filipino woman who developed progressive headache and visual disturbances on postpartum day 11 following an uncomplicated cesarean delivery with epidural anesthesia. Neuroimaging revealed subarachnoid blood in the right fronto-temporo-parietal sulci and Sylvian fissure without evidence of aneurysm or vascular malformation on angiography. She was managed with nimodipine, analgesics, and blood pressure control.

This case highlights diagnostic challenges in postpartum SAH, particularly in women without traditional risk factors or clear radiographic evidence of aneurysm. Early recognition and timely management can improve outcomes and prevent complications. Awareness of non-aneurysmal postpartum SAH may help clinicians broaden differential diagnoses when evaluating postpartum women with severe headache, facilitating accurate and timely care.