Archives of Gynecology and Obstetrics

, Volume 248, Issue 3, pp 151–155 | Cite as

Neurological cause of late postpartum seizures

  • F. Rosenow
  • M. Huber
  • W. Scheidt
  • W. -D. Heiß
Case Reports


A 32-year-old primigravida showed signs of pre-eclampsia before delivery of a healthy boy at term. The CSF-space was accidentally punctured during epidural anaesthesia in labour. One day later hypertension was noted and the patient had a single generalized fit. For the next three weeks she had postural headaches, fluctuating hypertension, intermittent hearing loss and doublevision. On the 22nd day of postpartum, the patient had the first of a series of partial and later generalized seizures, followed by hemiparesis, alteration of consciousness, and finally slow recovery with corticosteroid therapy. Bilateral subdural effusions and generalized meningeal thickening were found on MR scans. Repeated MRI excluded sinus thrombosis and documented the response to treatment.

Key words

Eclampsia complications Subdural effusion Meningeal thickening focal seizures Magnetic resonance imaging 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Alajouanine T, Hornet T, Pocliewiz AJ (1936) Oedeme cerebral generalize avec vasodilatation diffuse a l'examen anatomique d'une cas d'eclampsie tardive du postpartum avec hemorragie meningee et hemorragie placentaire (Etude anatomo-clinique et pathogenique). Rev Neurolog 65:276–290Google Scholar
  2. 2.
    Bolton VE, Leicht CH, Scanlon TS (1989) Postpartum seizure after epidural blood patch and intravenous caffeine sodium Benzoate. Anaesthesiology 70:146–149Google Scholar
  3. 3.
    Brownridge P (1983) The management of headache following accidental dural puncture in obstetric patients. Anaest Intens Care 11:4–15Google Scholar
  4. 4.
    Calabrese LH, Mallek JA (1987) Primary angiitis of the central nervous system. Medicine 67:20–39Google Scholar
  5. 5.
    Dawkins CJM (1969) Analysis of the complications of extradural and caudal block. Anaesthesia 24:554–463PubMedGoogle Scholar
  6. 6.
    Phillips OC, Ebner H, Nelson AT, Black MH (1969) Neurologic complications following spinal anaesthesia with lignocain: A prospective review of 10,440 cases. Anesthesiology 30:284–289PubMedGoogle Scholar
  7. 7.
    Sheehan HL, Lynch JB (1973) Pathology of toxaemia of pregnancy. Churchill Livingstone, Edinburgh, p 554–582Google Scholar
  8. 8.
    Vandam LD, Dripps RD (1956) Longterm follow-up of patients who received 10,098 spinal anesthetics-III Syndrome of decreased intracraniel pressure (Headache and ocular and auditory difficulties). JAMA 161:586–591Google Scholar
  9. 9.
    Vandam LD, Dripps RD (1960) Longterm follow-up of patients who received 10,098 spinal anesthetics-IV. Neurologic disease incident to traumatic lumbar puncture during spinal anesthesia. JAMA 172:79–83Google Scholar
  10. 10.
    Vercauteren MP, Vundelinckx GJ, Hanegreefs GH (1988) Postpartum headache, seizures and Bloodstained CSF: a possible complication of dural puncture? Intensive Care Med 14:176–177CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • F. Rosenow
    • 2
  • M. Huber
    • 2
  • W. Scheidt
    • 1
  • W. -D. Heiß
    • 2
  1. 1.Institute of RadiologyCologneFRG
  2. 2.Universitätsklinik und Poliklinik für NeurologieKöln 41FRG

Personalised recommendations