A healthy 25-year-old primigravida, at 38 weeks and 4 days of pregnancy, was admitted to our hospital in active labor. Epidural anesthesia was administered; the patient underwent a cesarean section due to cervical dystocia and a healthy boy was delivered. Orthostatic headache was noted 1 day after, and suspecting an accidental dural puncture, a therapy with paracetamol, hydration, and bed rest was administrated. The headache was stable, and a brain magnetic resonance imaging (MRI) study was proposed, but not executed because of patient refusal. Lumbar spinal MRI, blood pressure recordings, and blood tests were all normal. On Postpartum Day 8, the patient had a generalized tonic–clonic seizure that was terminated with diazepam. A brain computed tomography (CT) scan was performed, which showed a small amount of subarachnoid hemorrhage. At the end of the scan, the patient had a second seizure that was treated with midazolam, sedation, and intubation. A CT angiogram showed no evidence of vascular malformations. A subsequent MRI scan showed MRI multiple bilateral T2-weighted hyperintensity in the cortical and subcortical white matter, subarachnoid hyperintensity on fluid attenuated inversion recovery sequences, and leptomeningeal enhancement. Vasogenic edema was suspected in diffusion weighted images (Figure 1).
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