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Neuro

Neuro 3

14 May, 2026

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A post-partum patient presents with seizures. What's the diagnosis?

Findings highly suggestive of intracranial hypotension, which may be due to a lumbar CSF leak in this clinical context are present. There are bilateral subdural haematohygromas, subtle decreased fluid within the optic sheaths, and distention of the dural venous sinuses, particularly the superior sagittal and transverse sinuses. A history of spinal or epidural anaesthesia should be sought, and full spine MRI may be of use

Test Your Knowledge

1. A post-partum patient presents with seizures. Which condition is the most likely diagnosis?

Sample answer. Migraine with aura would not typically cause new-onset seizures in a post-partum patient — look for venous abnormalities on imaging.

Sample answer. The post-partum period is a known pro-thrombotic state, and CVST classically presents with seizures, headache, and focal neurological deficits.

Sample answer. Eclampsia is on the differential, but imaging findings here favour a sinus thrombosis pattern.

Sample answer. PRES is a reasonable differential in the post-partum setting but imaging usually shows posterior parieto-occipital vasogenic oedema rather than venous thrombus.

2. Which imaging finding would best confirm the diagnosis?

Sample answer. MR venography demonstrating absent flow or a filling defect within a dural venous sinus is the most specific confirmatory finding.

Sample answer. Cortical ribboning suggests CJD or hypoxic injury — not the pattern here.

Sample answer. That points to acute arterial occlusion, not venous thrombosis.