Anaesthetic management for craniotomy in a pregnant patient with rupture of a cerebral arterio-venous malformation: Case report
Keywords:
Cerebral, hemorrhage, Pregnancy, Craniotomy, Neurosurgical, procedures, Anesthesia
Abstract
Intracranial haemorrhage (ICH) is the third leading non-obstetric indirect cause of maternal death. We describe the anaesthetic management of a 32-year-old woman at 22 weeks gestation with intracranial haemorrhage due to a ruptured arteriovenous malformation (AVM). Managing these patients requires a complex approach with a highly individualised plan involving neurosurgeons, neuroradiologists, anaesthetists, obstetricians and neonatologists to assess the risk and benefit of all the different therapeutic alternatives. Given the high risk of further bleeding during pregnancy and the location of the AVM, the best therapeutic option in this case was considered to be a craniotomy and complete removal of the lesion.
References
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11. Monsalve-Mejía G, Palacio W, Rodríguez C. Emergency cesarean section and craniectomy in a patient with rupture of a cerebral arteriovenous malformation. Rev Esp Anestesiol Reanim. 2014;61:209-13.
2. Dashti SR, Spalding AC, Yao TL. Multimodality treatment of ruptured grade IV posterior fossa arteriovenous malformation in a patient pregnant with twins: case report. J Neurointerv Surg. 2012;4:e21.
3. Le LT, Wendling A. Anesthetic management for cesarean section in a patient with rupture of a cerebellar arteriovenous malformation. J Clin Anesth. 2009;21: 143-8.
4. Jermakowicz WJ, Tomycz LD, Ghiassi M, Singer RJ. Use of endovascular embolization to treat a ruptured arteriovenous malformation in a pregnant woman: a case report. J Med Case Rep. 2012;6:113.
5. Wang LP, Paech MJ. Neuroanesthesia for the pregnant woman. Anesth Analg. 2008;107:193-200.
6. Sinha PK, Neema PK, Rathod RC. Anesthesia and intracranial arteriovenous malformation. Neurol India. 2004;52: 163-70.
7. Coskun D, Mahli A, Yilmaz Z, Cizmeci P. Anesthetic management of caesarean section of a pregnant woman with cerebral arteriovenous malformation: a case report. Cases J. 2008;18:327.
8. Ní Mhuireachtaigh R, O'Gorman DA. Anesthesia in pregnant patients for nonobstetric surgery. J Clin Anesth. 2006;18: 60-6.
9. Reitman E, Flood P. Anaesthetic considerations for non-obstetric surgery during pregnancy. Br J Anaesth. 2011;107 Suppl. 1:i72-8.
10. Carvalho CS, Resende F, Centeno MJ, Ribeiro I, Moreira J. Anesthetic approach of pregnant woman with cerebral arteriovenous malformation and subarachnoid hemorrhage during pregnancy: case report. Braz J Anesthesiol. 2013;63:223-6.
11. Monsalve-Mejía G, Palacio W, Rodríguez C. Emergency cesarean section and craniectomy in a patient with rupture of a cerebral arteriovenous malformation. Rev Esp Anestesiol Reanim. 2014;61:209-13.
How to Cite
1.
Guerrero-Domínguez R, Rubio-Romero R, López-Herrera-Rodríguez D, Federero F, Jiménez I. Anaesthetic management for craniotomy in a pregnant patient with rupture of a cerebral arterio-venous malformation: Case report. Colomb. J. Anesthesiol. [Internet]. 2015 Jul. 1 [cited 2024 Apr. 25];43(Supplement):57-60. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/737
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Published
2015-07-01
How to Cite
1.
Guerrero-Domínguez R, Rubio-Romero R, López-Herrera-Rodríguez D, Federero F, Jiménez I. Anaesthetic management for craniotomy in a pregnant patient with rupture of a cerebral arterio-venous malformation: Case report. Colomb. J. Anesthesiol. [Internet]. 2015 Jul. 1 [cited 2024 Apr. 25];43(Supplement):57-60. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/737
Section
Case Report / Case Series
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