Reversible cerebral vasoconstriction syndrome during caesarean section.

Autor:	Safran SL; Service d'anesthésiologie et de réanimation du CHVR, Hopital du Valais, Sion, Switzerland.; Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland., Balmer C; Service d'anesthésiologie et de réanimation du CHVR, Hopital du Valais, Sion, Switzerland., Savoldelli G; Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland Georges.savoldelli@hcuge.ch.; Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	BMJ case reports [BMJ Case Rep] 2019 Dec 05; Vol. 12 (12). Date of Electronic Publication: 2019 Dec 05.
DOI:	10.1136/bcr-2019-230606
Abstrakt:	We describe the case of a 25-year-old parturient who presented sudden onset and short-lived severe headache caused by reversible cerebral vasoconstriction syndrome (RCVS) during an emergency caesarean section. The syndrome was triggered by phenylephrine administered intravenously to correct arterial hypotension following spinal anaesthesia. RCVS is a clinical and radiological syndrome attributed to transient disturbance in the control of cerebral arterial tone resulting in vasospasms. The syndrome can be precipitated by several triggers, including vasoactive drugs, often used during spinal anaesthesia, illicit drugs, pregnancy and postpartum state. Diagnosis and management can be challenging during pregnancy, peripartum or post partum, since many medications commonly used during these periods must be avoided to prevent triggering RCVS. The aim of this report is to raise the awareness, particularly for anaesthesiologists and obstetricians, of this rare and potentially serious syndrome. We discuss diagnosis, triggers, pathogenesis, clinical course and complications, as well as coordinated multidisciplinary management plans. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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