American Board of Psychiatry and Neurology (ABPN) Practice Exam

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What is the most likely diagnosis for a woman experiencing an acute onset of headaches and seizures within a week after childbirth?

  1. Aseptic meningitis

  2. Cerebral venous thrombosis

  3. Complicated migraine

  4. Pseudotumor cerebri

The correct answer is: Cerebral venous thrombosis

The most likely diagnosis for a woman experiencing an acute onset of headaches and seizures within a week after childbirth is cerebral venous thrombosis (CVT). This condition is particularly relevant in the postpartum period due to changes in coagulation status that occur during pregnancy and the immediate postpartum period, which increase the risk for thrombotic events. Cerebral venous thrombosis can present with varied neurological symptoms, including headaches, seizures, and sometimes focal neurological deficits. The acute onset of these symptoms shortly after childbirth suggests an underlying vascular issue related to the hormonal changes and increased venous pressure that can accompany the postpartum state. Additionally, CVT can be associated with risk factors such as dehydration, infection, or the presence of certain medical conditions that are more prevalent after delivery. In this case, the timing of symptom onset—within a week of delivery—aligns with the known clinical picture of CVT. Other potential diagnoses may present with overlapping symptoms, but the specific context of postpartum risk and the acute neurological presentation strongly point toward CVT as the most likely diagnosis.