Subarachnoid Haemorrhage Following Caesarean Delivery in a Woman with Multiple Sclerosis: Case Report and Discussion

Background: Seizures and cerebral bleeding during pregnancy are uncommon but carry significant maternal and neonatal risks.When they occur postpartum, particularly in women with pre-existing neurological conditions such as multiple sclerosis (MS), diagnostic complexity increases. Case presentation:We report a case of a 25-year-old primigravida with a longstanding diagnosis of MS, who underwent elective lower uterine segment caesarean section (LUSCS) at term.Shortly after delivery, she experienced a sudden severe headache, acute hypertension, and a generalised tonic-clonic seizure.Imaging revealed bilateral frontal SAH with no aneurysm or thrombosis.MRI also demonstrated a new pontine demyelinating lesion.She was managed conservatively with ICU support and early postpartum immunotherapy.Follow-up showed full clinical recovery.Discussion: This case highlights the intersecting vulnerabilities of postpartum neurophysiology and chronic demyelinating disease.The differential diagnosis encompassed eclampsia, PRES, and seizure-induced SAH.The presence of MS may have predisposed to neurovascular fragility and cortical irritability in the postpartum setting. Conclusion:Non-aneurysmal SAH in the early postpartum period remains a diagnostic and therapeutic challenge, particularly in women with chronic neurological disease.Multidisciplinary care and anticipatory planning are essential to optimise maternal outcomes in future pregnancies.