Postpartum Preeclampsia Manifesting as a Transient Ischemic Attack: A Case Report on the Multidisciplinary Management of a High-Risk Patient

TL;DR

A woman developed postpartum preeclampsia that caused a transient ischemic attack, highlighting the need for close monitoring and multidisciplinary care in high-risk patients.

Contribution

This case report presents a rare instance of postpartum preeclampsia manifesting as a TIA and suggests a potential link with chronic sinusitis.

Findings

Postpartum preeclampsia can present as a TIA with neurological symptoms like weakness and slurred speech.

The patient's symptoms resolved quickly with antiplatelet therapy, antihypertensives, and seizure prophylaxis.

Chronic sinusitis was observed alongside preeclampsia, suggesting a possible but unproven connection.

Abstract

Transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by focal brain ischemia, typically lasting less than one hour without acute infarction. Preeclampsia, a multisystem hypertensive disorder occurring in pregnancy, significantly heightens the risk of stroke, particularly during the postpartum period.

This case report details a 34-year-old Sub-Saharan African woman, gravida 4 para 4, who experienced a TIA characterized by right-sided weakness and slurred speech 13 days after delivering a baby by cesarean section. Upon presentation to the emergency department with symptoms suggesting a minor stroke, clinical examination revealed hypertension and neurological deficits. Imaging studies clarified the absence of acute intracranial pathology but indicated hypoperfusion in the right frontal white matter and significant chronic sinusitis. The patient's elevated blood pressure and clinical conditions were consistent with postpartum preeclampsia.

Management included dual antiplatelet therapy and antihypertensives alongside seizure prophylaxis. The patient's neurological symptoms resolved within 24 hours, and she was discharged on supportive medications, with follow-up arrangements established for various specialties.

This case emphasizes the need for careful monitoring of postpartum women for signs of preeclampsia and cerebrovascular events, particularly in high-risk populations. It highlights the interaction between these conditions and the importance of collaborative multidisciplinary care. Further research is warranted to explore the link between chronic sinusitis and postpartum preeclampsia.

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