Subarachnoid hemorrhages (SAH) due to true aneurysms of the Posterior Cerebral Artery (PCA) during puerperium in young and healthy females are extremely rare. Circulatory disorders, cerebrovascular diseases and hemorrhagic stroke are associated with pregnancy, delivery and puerperium. In the Western world, maternal aneurismal subarachnoid hemorrhage (SAH) occurs in 8 31 per 100,000 deliveries and accounts for up to 10% of maternal deaths in pregnant women . In an epidemiological survey Jung et al. investigated a history of hypertension and diabetes, a family history of stroke, smoking status and alcohol consumption as potential confounders of hemorrhagic stroke in 471 women with parity. Particularly pregnant women, suffering from preeclampsia-eclampsia or cardiomyopathy are at high risk. Transient degeneration and turnover of the
vessel wall presumably based on hormonal changes - in combination with postpartum or pregnancy-related hypertension as potential causes of aneurysm formation and rupture. Despite the relatively low overall-risk in young and healthy women for SAH due to intracerebral aneurysms during pregnancy, delivery and puerperium, one should have a high degree of suspicion in any case of neurological deterioration. Immediate radiological diagnosis of the SAH and of the aneurysm is mandatory and early neurosurgical/neuroradiological intervention should be achieved.
Last date updated on July, 2014