Introduction: Severe preeclampsia may progress to major neurological complications and HELLP syndrome (1,2). Subarachnoid hemorrhage (SAH) in this context is rare but associated with high maternal morbidity. Early recognition and multidisciplinary management are essential to improve maternal outcomes. Case Presentation: A 35-year-old primigravida at 30 weeks of gestation presented to the obstetric emergency department, where a diagnosis of severe preeclampsia was made. A Kerr-type cesarean section was performed due to maternal–fetal deterioration. In the immediate postpartum period, she developed Mississippi Class II HELLP syndrome requiring management in the Obstetric Intensive Care Unit. She subsequently presented with headache and visual disturbances. Head CT revealed diffuse right frontoparietotemporal SAH (Fisher II) with vasogenic edema. Neurosurgical evaluation determined no need for urgent intervention. The patient improved with antihypertensive therapy, neuroprotection, and close monitoring. Conclusions: SAH may occur as a postpartum complication in patients with preeclampsia/HELLP (7,8). Persistent headache or visual symptoms in these patients should prompt evaluation for intracranial hemorrhage. Multidisciplinary management is essential.
Díaz et al. (Wed,) studied this question.