Antonino Sambundo Benjamin Kapitão^1-3*, Eládio Geraldo Palanga^1,2, José Domingos Paiva^1,2, Raúl Fernandes Tchitali^1,2 and Arlete Celina dos Santos E Soy¹

¹Physician and PhD in Biomolecular Sciences, Katyavala Bwila University, Benguela, Angola ²General Physician, Department of Internal Medicine, General Hospital of Benguela, Benguela, Angola ³Medical Student, Jean Piaget Higher Polytechnic Institute of Benguela, Benguela, Angola

*Corresponding Author: Antonino Sambundo Benjamin Kapitão, Physician and PhD in Biomolecular Sciences, Katyavala Bwila University, Benguela, Angola.

Received: September 29, 2025; Published: October 27, 2025

Abstract

Stroke in the puerperium is rare but potentially fatal, with significant morbidity in young women. Physiological and hemodynamic changes of pregnancy, particularly when associated with hypertensive disorders, increase cerebrovascular risk. Reports from Sub-Saharan Africa remain scarce. We present the case of a 38-year-old multiparous woman from Benguela, Angola, who developed sudden severe headache and loss of consciousness one week postpartum. She had gestational hypertension diagnosed at 37 weeks. On admission, she was unconscious (Glasgow Coma Scale = 9) with severe hypertension (180/100 mmHg). Cranial computed tomography showed a large left capsuloganglionic hematoma with intraventricular extension. She was managed with strict blood pressure control, osmotic diuretics, nimodipine, and oxygen therapy. Follow-up imaging revealed ventricular dilatation as a post-stroke sequela. This case emphasizes gestational hypertension as a major determinant of postpartum hemorrhagic stroke and represents the first documented report from Angola, highlighting the need for timely diagnosis and multidisciplinary management in resource-limited settings.

Keywords: Postpartum Stroke; Hemorrhagic Stroke; Gestational Hypertension; Puerperium, Sub-Saharan Africa

References

1. S Rl., et al. “An updated definition of stroke for the 21^st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association”. Stroke7 (2013).
2. GBD 2021 Stroke Risk Factor Collaborators. “Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021”. Lancet Neurology10 (2024): 973-1003.
3. R H Swartz., et al. “The incidence of pregnancy-related stroke: A systematic review and meta-analysis”. International Journal of Stroke O7 (2017): 687-697.
4. S J Kittner., et al. “Pregnancy and the risk of stroke”. The New England Journal of Medicine 11 (1996): 768-774.
5. L R Leffert., et al. “Hypertensive disorders and pregnancy-related stroke: frequency, trends, risk factors, and outcomes”. Obstetrics and Gynecology 1 (2015): 124-131.
6. A Morton. “Physiological Changes and Cardiovascular Investigations in Pregnancy”. Heart, Lung and Circulation1 (2021): e6-e15.
7. A Y Yu., et al. “Maternal Health Outcomes After Pregnancy-Associated Stroke: A Population-Based Study With 19 Years of Follow-Up”. Stroke2 (2023): 337-344.
8. S D Treadwell., et al. “Stroke in pregnancy and the puerperium”. Postgraduate Medical Journal991 (2008): 238-245.
9. M Arnold., et al. “Postpartum cervicocephalic artery dissection”. Stroke8 (2008): 2377-2379.
10. S M Silvis., et al. “Cerebral venous thrombosis”. Nature Reviews Neurology 9 (2017): 555-565.
11. EV Kuklina., et al. “Trends in pregnancy hospitalizations that included a stroke in the United States from 1994 to 2007: reasons for concern?”. Stroke9 (2011): 2564-2570.
12. A H James., et al. “Incidence and risk factors for stroke in pregnancy and the puerperium”. Obstetrics and Gynecology3 (2005): 509-516.
13. A G Witlin., et al. “Postpartum stroke: a twenty-year experience”. American Journal of Obstetrics and Gynecology1 (2000): 83-88.
14. LR Leffert., et al. “Hypertensive disorders and pregnancy-related stroke: frequency, trends, risk factors, and outcomes”. Obstetrics and Gynecology1 (2015): 124-131.
15. J M Lappin., et al. “Fatal Stroke in Pregnancy and the Puerperium”. Stroke12 (2018): 3050-3053.
16. SM Greenberg., et al. “2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association”. Stroke7 (2022): e282-e361.
17. L S Mehta., et al. “Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association”. Circulation23 (2020): e884-e903.
18. L Chen., et al. “Patent foramen ovale (PFO), stroke and pregnancy”. Journal of Investigative Medicine 5 (2016): 992-1000.

Citation

Citation: Antonino Sambundo Benjamin Kapitão., et al. “Postpartum Hemorrhagic Stroke in African Maternal Care: A Case-Based Review from Benguela, Angola". Acta Scientific Women's Health 7.11 (2025): 14-17.

Copyright

Copyright: © 2025 Antonino Sambundo Benjamin Kapitão., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.