Preeclampsia with Hemorrhagic Stroke: A Case Report of a Woman’s Perilous Journey through Motherhood with a Miraculous Ending

Abstract

Aim and objective: The aim of the study was to highlight the infrequent occurrence and timely multidisciplinary management of hemorrhagic stroke in preeclampsia (PE), thereby averting serious maternal and fetal morbidity and mortality. Background: Hemorrhagic stroke is a result of severe PE, which is a known but fortunately uncommon complication. In comparison with nonpregnant women, stroke rates are relatively rare during pregnancy. Despite the high maternal and fetal mortality rates in such a scenario, we report a case where the outcome for both mother and infant was excellent. Case description: We report the case of a 23-year-old primigravida who presented at 32 weeks 6 days period of gestation with sudden onset of right-sided hemiplegia associated with aphasia and blood pressure (BP) of 200/120 mm Hg. Cerebral computed tomography (CT) scan confirmed a left frontoparietal lobe parenchymal hemorrhage with intraventricular extension. Emergency Cesarean delivery was done followed by left frontotemporoparietal decompression craniotomy with intracranial hemorrhage (ICH)’s evacuation. She recovered completely without any neurological deficit. Conclusion: Acute cerebrovascular accidents are a challenge in both diagnosis and management when it involves a pregnant woman. Early diagnosis using CT and a multidisciplinary approach will help reduce maternal mortality and morbidity in cases where the stroke is suspected. Clinical significance: The significance of optimal control of BP in patients with hypertensive pregnancy disorders cannot be overemphasized. As per the primary prevention, the patient’s education at first contact with health care about the PE is a sine qua non, emphasizing antihypertensive compliance.