Nonsurgical Approach to Postpartum Cortical Venous Thrombosis with Hemorrhagic Transformation and Subfalcine Herniation: A Case Report

Abstract Cerebral venous thrombosis (CVT) is a rare but serious postpartum complication that can present with hemorrhagic infarction and mass effects. We report a postpartum woman from a low-resource setting who presented with headache and focal deficits. Initial CT revealed right frontal edema with early subfalcine herniation; MRI confirmed hemorrhagic venous infarction with an 8 mm midline shift, and the superior sagittal sinus remained patent. Despite significant mass effect, she was successfully managed nonsurgical through a multidisciplinary approach involving anticoagulation, seizure prophylaxis, anemia correction, intracranial pressure control, and neurocritical care leading to full recovery. This case underscores the potential for effective diagnosis and management of herniation-associated CVT even in low-resource settings, when multidisciplinary coordination and timely imaging are available.