Hemorrhagic moyamoya disease during pregnancy
| Autor: | Christopher R. Honey, John C.L. Sun, Margaret Yakimov, Ismail Al-Badawi |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Gynecology
Adult Postoperative Care medicine.medical_specialty business.industry Cesarean Section Pregnancy Complications Cardiovascular Pregnancy Complications Hematologic General Medicine medicine.disease Surgery Fatal Outcome Neurology Pregnancy medicine Humans Female Neurology (clinical) Moyamoya disease Moyamoya Disease business Tomography X-Ray Computed Intracranial Hemorrhages |
| Zdroj: | The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques. 27(1) |
| ISSN: | 0317-1671 |
| Popis: | Background:Intracranial hemorrhage in pregnant patients with Moyamoya disease is rare. We review the case of one such patient who presented with pre-eclampsia and a catastrophic intracerebral hemorrhage in order to highlight the associated management difficulties.Methods:A case of a pregnant (31 weeks) female brought to the emergency department with hypertension and a progressive decrease in her level of consciousness is presented. She rapidly developed a dilated right pupil and left extensor posturing. A CT scan of her head showed a large putamenal intracerebral hemorrhage. She was intubated, ventilated and given intravenous mannitol and magnesium sulfate. She underwent a simultaneous craniotomy and Cesarean section. Post-operatively the patient's ICP and jugular venous saturation were monitored in the intensive care unit.Results:The patient delivered a 1185g infant who did well. The patient's ICP was well controlled until the tenth post-operative day when she developed malignant brain edema and died.Conclusion:This case highlights three important points. First, simultaneous craniotomy and Cesarean section can be performed. Second, intraoperative control of bleeding Moyamoya vessels is described. Third, the difficult post-operative management of these cases is highlighted. The literature regarding Moyamoya disease and pregnancy is reviewed and some recommendations for the management of this rare but potentially deadly condition are presented. |
| Databáze: | OpenAIRE |
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