Primary Spontaneous Intracerebral Hemorrhage in Pregnancy: A Case Report with Literature Review

Intracranial Hemorrhage (ICH) during pregnancy is an uncommon but life-threatening neurological emergency associated with substantial maternal and fetal morbidity and mortality. Although most cases arise from hypertensive disorders of pregnancy or underlying structural cerebrovascular lesions, spontaneous ICH without an identifiable etiology can occur and poses significant diagnostic and management challenges. We describe a ۲۳-year-old primigravida at ۲۳ weeks’ gestation who presented with sudden loss of consciousness following a severe headache and repeated vomiting, with no history of hypertension, trauma, or pre‑existing neurological disease. Cranial computed tomography demonstrated a large right frontal intracerebral hemorrhage with midline shift, accompanied by an epidural hemorrhage. Emergency craniotomy with hematoma evacuation resulted in rapid neurological recovery without residual deficits. Maternal stabilization and timely neurosurgical intervention enabled continuation of the pregnancy to term with favorable maternal and neonatal outcomes. Early recognition, prompt neuroimaging, and coordinated multidisciplinary management are essential to optimizing maternal and fetal outcomes.

کلیدواژه ها:

intracerebral hemorrhage ، intracranial hemorrhage ، mid-trimester ، Pregnancy ، Spontaneous ، Stroke