title: Sheehan syndrome: acute presentation with severe headache.
abstract: Postpartum headache is a common occurrence with a broad differential diagnosis. Sheehan syndrome, or postpartum pituitary necrosis, is not typically recognized as a cause of postpartum headache. We present a case of Sheehan syndrome that initially presented as severe headache after vaginal delivery complicated by retained placenta and postpartum hemorrhage. The patient was discharged home on postpartum day three but continued to have headaches and returned to hospital on postpartum day six with severe headache, failure to lactate, edema, dizziness, fatigue, nausea and vomiting. Cranial magnetic resonance imaging revealed pituitary infarction consistent with Sheehan syndrome. We discuss the differential diagnosis for postpartum headache, the pathophysiological features of Sheehan syndrome and headache as an atypical acute presentation.
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: B
authors.initials: B
authors.lastname: Hale
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA. Electronic address: habib001@dm.duke.edu.
authors.forename: A S
authors.initials: AS
authors.lastname: Habib
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D003937:Diagnosis, Differential; D004573:Electrolytes / Q000097:blood; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D010901:Pituitary Function Tests; D018457:Placenta, Retained / Q000473:pathology / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000473:pathology / Q000628:therapy; D049590:Postpartum Period; D011247:Pregnancy
chemical_list: D004573:Electrolytes
keywords: Postpartum headache; Sheehan syndrome