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Clinical Mysteries • Neurology

The Headache After Delivery

The presentation

Days after delivery, a woman developed severe headache and a focal seizure.

The first explanation was plausible, but the pattern did not fully fit. A deliberate second look focused on physiology, medication/exposure history, serial observations and the clue that the initial diagnosis could not explain.

The turn

The postpartum prothrombotic state and neurological features demanded venous imaging.

Diagnosis

Cerebral venous sinus thrombosis

Why this case matters

Postpartum headache plus neurology is a red flag.

Take-home message: When the clinical course contradicts the working diagnosis, stop escalating the same treatment and rebuild the problem from first principles.