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March 22, 2026Cureus0 citationsOpen Access

Postpartum Ischemic Stroke As the First Manifestation of Late-Onset Preeclampsia: A Case Report

IBIliass BenainiMAMeriam AzirarABAmine Bensaid

Key Result

A 33-year-old woman with late-onset preeclampsia presenting as a postpartum ischemic stroke achieved full neurological recovery within six weeks of antihypertensive and antiplatelet therapy.

Key Points

  • This report aims to highlight the link between postpartum ischemic stroke and late-onset preeclampsia.
  • Reported case of a 33-year-old woman after cesarean delivery
  • Monitored blood pressure and conducted laboratory tests
  • Performed brain MRI to assess ischemic lesions
  • Administered treatments including acetylsalicylic acid and antihypertensives
  • Identified significant ischemic lesions consistent with subacute infarction
  • Patient experienced full neurological recovery within six weeks
  • Recommended prophylaxis for future pregnancies

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
33-year-old multiparous woman presenting with sudden left-sided hemiparesis and other neurological deficits within 24 hours after a cesarean delivery, diagnosed with late-onset preeclampsia.
I
Intervention
Acetylsalicylic acid (75 mg/day), levetiracetam (500 mg/12h), and antihypertensive therapy (methyldopa 500 mg/8h and continuous intravenous nicardipine).
O
Outcome
Neurological recovery

This case highlights the importance of considering late-onset preeclampsia as a potential underlying cause of postpartum ischemic stroke, emphasizing the need for early recognition and timely neuroimaging.

Limitations

  • Absence of dedicated vascular imaging (MRA)
  • absence of dedicated vascular imaging (MRA)

Abstract

Preeclampsia is a severe pregnancy hypertensive disorder characterized by arterial hypertension and multiorgan involvement, most frequently affecting the renal, hepatic, and neurological systems. While its typical manifestations include headaches, visual disturbances, and/or epigastric pain, atypical presentations may occur and may lead to life-threatening complications. We report the case of a 33-year-old multiparous woman who developed sudden left-sided hemiparesis, hemisensory loss, homonymous hemianopia, and rightward conjugate gaze deviation within 24 hours after a cesarean delivery. Blood pressure was 169/103 mmHg. Laboratory tests revealed moderate anemia, elevated LDH, low haptoglobin, and significant proteinuria (4.84 g/24h). Brain MRI demonstrated ischemic lesions in the right fronto-parieto-insular cortico-subcortical regions, consistent with a subacute infarction. The diagnosis of preeclampsia complicated by ischemic stroke was established. The patient was treated with acetylsalicylic acid, levetiracetam, and antihypertensive therapy (methyldopa and nicardipine). She progressively improved and achieved full neurological recovery within six weeks. Prophylaxis with low-dose aspirin and low molecular weight heparin was recommended for future pregnancies. This case highlights the importance of considering preeclampsia as a potential underlying cause of postpartum ischemic stroke. Early recognition of neurological symptoms and timely neuroimaging are critical to prevent severe maternal morbidity.

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Cite This Study

Benaini et al. (2026) conducted a case report in Postpartum ischemic stroke and late-onset preeclampsia (n=1). Acetylsalicylic acid, levetiracetam, methyldopa, and nicardipine was evaluated on Neurological recovery. A 33-year-old woman with late-onset preeclampsia presenting as a postpartum ischemic stroke achieved full neurological recovery within six weeks of antihypertensive and antiplatelet therapy.

synapsesocial.com/papers/69bf8641f665edcd009e8cb1https://doi.org/10.7759/cureus.105545
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