Neurocysticercosis presenting as a subdural hematoma in the postpartum period: a diagnostic challenge

Neurocysticercosis is the most common parasitic infection of the human central nervous system, caused by the larval stage of Taenia solium. Its clinical manifestations vary widely, ranging from asymptomatic cases to seizures, focal neurological deficits, and increased intracranial pressure. The postpartum period involves significant immunological, hormonal, and metabolic changes that may influence the onset, progression, or presentation of infectious diseases. This report presents a rare case of neurocysticercosis presenting as a subdural hematoma during the postpartum period. A twenty-one-year-old woman with no previous medical history was admitted thirty-five days after cesarean section due to severe headache and speech impairment. Cranial computed tomography revealed a left-sided subdural hematoma measuring fifteen millimeters in thickness, associated with a seven-millimeter midline shift. The patient underwent emergency craniotomy to evacuate the hematoma. Histopathological examination of the surgical specimen confirmed the presence of the larval form of Taenia solium, thereby establishing the diagnosis of neurocysticercosis. Following surgery, the patient experienced seizures, which required intensified antiepileptic medication. Antiparasitic treatment consisting of albendazole and corticosteroids was initiated. Further radiological evaluations, including cranial and spinal magnetic resonance imaging, did not identify any additional cystic lesions. The patient responded well to treatment and was discharged on hospital day twenty-three with mild speech impairment. At the one-month follow-up visit, her neurological examination was entirely normal. This case highlights an unusual presentation of neurocysticercosis in the postpartum period and underscores the importance of considering this diagnosis in patients presenting with seizures or subdural hematoma in endemic regions.