A case of postpartum cerebral angiitis and review of the literature

Purpose To better characterize postpartum cerebral angiitis (PPCA). Methods We present a case of PPCA in which a 34-year-old G6P5104 underwent a normal vaginal delivery and developed PPCA. She had no signs or symptoms of gestational hypertension or preeclampsia. She had a history of migraines and received methylergonovine at delivery. She represented postpartum with headache and hypertension. The patient had characteristic findings of cerebral angiitis on imaging, and was diagnosed with PPCA. She was treated with nimodipine and steroids. She was monitored with transcranial Dopplers. Results In reviewing the literature, we found 23 cases of PPCA. We found that none had proteinuria, most were hypertensive, and all presented with headache. Conclusions Use of sympathomimetic agents, particularly among those with migraines, may increase risk of PPCA.