Peripartum asymptomatic cerebral hemorrhage (PEACH)

Abstract

We report a case of peripartum asymptomatic cerebral hemorrhage (hereafter “PEACH”) in the frontal lobe, which was not diagnosed until postpartum day 8. A 35-year-old woman underwent cesarean section at 40 weeks of gestation due to non-reassuring fetal status during labor and gave birth to a healthy female baby. Her general conditions during labor, cesarean delivery, and postpartum period were uneventful. However, she developed hypertension 8 days after delivery, had headache and vertigo, and could not maintain a sitting position. Computed tomography revealed an edematous lesion in the vicinity of a hemorrhagic lesion in the right frontal cortex. Diffusion-weighted magnetic resonance imaging confirmed these findings, suggesting that several days or more had passed since the occurrence of asymptomatic cerebral hemorrhage. PEACH may occur in normotensive patients and cause nerve compression symptoms and hypertension over the course of a few days.