Reversible Cerebral Vasoconstriction Syndrome with Subarachnoid Hemorrhage in the Postpartum Period: A Rare Case Scenario

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare, reversible condition characterized by segmental narrowing of cerebral arteries, often presenting with thunderclap headaches and various neurological deficits. This case report describes a 29-year-old multigravida who presented in the postpartum period with sudden onset of severe headache, seizures, and right-sided hemiplegia. Imaging revealed subarachnoid hemorrhage (SAH), infarctions in watershed areas, and segmental vasoconstriction of cerebral arteries on MRA. The patient was managed with antiepileptics, antihypertensives, and supportive care, resulting in full recovery within one month. This case underscores the importance of considering RCVS in postpartum patients with neurological symptoms to ensure prompt diagnosis and management. Similar cases in the literature emphasize the variable presentation and the need for high clinical suspicion to prevent misdiagnosis and inappropriate treatment.