![]() ![]() She was found to have a hemoglobin of 5.8 g/dL on postpartum day 3 and was transfused with one unit of packed red blood cells which increased her hemoglobin to 8.1 g/dL. The patient experienced persistent vaginal bleeding following delivery, but her postpartum course was otherwise uncomplicated. The patient underwent a primary low-transverse cesarean section at 40 weeks and 0 days that was complicated by an estimated 600 mL blood loss. The patient’s pregnancy course had been complicated by preeclampsia without severe features, chorioamnionitis, and iron-deficiency anemia that was present before delivery. Prompt diagnosis and management of VAD is essential to ensure favorable outcomes.Ī 31-year-old Hispanic woman presented 10 days postpartum with a one-day history of vertigo, nausea, vomiting, and frontal headache. Women aged 30 years or older and those with a history of a hypertensive disorder of pregnancy are at particularly high risk. VAD is a rare but important cause of neurologic symptoms in the postpartum period and should be considered in the differential diagnosis for women who present with headache and/or vertigo. The patient was started on a heparin infusion and experienced significant improvement after a four-day hospitalization. Based on correlation of the clinical history and laboratory and imaging findings, a diagnosis of vertebral artery dissection secondary to reactive (secondary) thrombocytosis from overlapping iron-deficiency anemia and acute hemorrhage was established. Subsequent CT angiography of the head and neck showed a left VAD. Emergent computed tomography (CT) scan of the head was obtained and revealed a left cerebellar ischemic large vessel stroke. Laboratory studies showed marked thrombocytosis. Physical examination was significant for left leg ataxia. The patient’s pregnancy course had been complicated by preeclampsia, chorioamnionitis, and iron-deficiency anemia, and her delivery was complicated by acute hemorrhage. Case presentationĪ 31-year-old Hispanic woman presented 10 days postpartum with a one-day history of vertigo, nausea, vomiting, and frontal headache. In addition, we discuss the presentation, differential diagnosis, and pathogenesis of this uncommon but clinically significant vascular event and summarize other cases of vertebral artery dissection described in the medical literature. We describe a 31-year-old female who presented with vertigo, nausea, and vomiting and was found to have a VAD. Vertebral artery dissection (VAD), however, is rare. Hypertensive disorders of pregnancy are associated with vascular complications, including ischemic stroke and cervical artery dissection. ![]()
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