Complete recovery after antepartum massive intracerebral hemorrhage in an atypical case of sudden eclampsia

BACKGROUND: Intracerebral hemorrhage is an infrequent but severe complication in pregnant women with hypertension. CASE DESCRIPTION: We describe an atypical case of a patient with no risk factors who developed sudden eclampsia and spontaneous intracerebral hemorrhage during the 34(th) week of pregnancy. She underwent successful emergent Cesarean section followed by craniotomy. Both intraoperative surveillance and postoperative magnetic resonance angiographic examination of the cerebral vessels failed to identify an aneurysm, arteriovenous malformation, tumor, or leptomeningeal disease. CONCLUSION: We discuss the management of this case and review the literature regarding the threshold for which initiation of antihypertensive treatment is indicated in pregnant patients.