Subarachnoid Hemorrhage from Posterior Cerebral Artery Aneurysm during Puerperium – Case Report and Review of Literature

Circulatory disorders, cerebrovascular diseases and hemorrhagic stroke are associated with pregnancy, delivery and puerperium [1-3]. In the Western world, maternal aneurismal subarachnoid hemorrhage (SAH) occurs in 8 – 31 per 100,000 deliveries [4] and accounts for up to 10% of maternal deaths in pregnant women [5]. In an epidemiological survey Jung et al. [1] investigated a history of hypertension and diabetes, a family history of stroke, smoking status and alcohol consumption as potential confounders of hemorrhagic stroke in 471 women with parity. Particularly pregnant women, suffering from preeclampsia-eclampsia or cardiomyopathy are at high risk [3,6,7]. Some authors suggested transient degeneration and turnover of the vessel wall – presumably based on hormonal changes in combination with postpartum or pregnancy-related hypertension as potential causes of aneurysm formation and rupture [1,2,4,6,7].