Anaesthetic management for craniotomy in a pregnant patient with rupture of a cerebral arterio‐venous malformation: Case report☆. (2015)

• Record Type: Journal Article
• Authors: Guerrero‐Domínguez, Rosana; Rubio‐Romero, Rafael; López‐Herrera‐Rodríguez, Daniel; Federero, Francisco; Jiménez, Ignacio
• Is Part Of: Colombian journal of anesthesiology. Volume 43:Supplement 1(2015)
• Publication Date: 2015
• Subjects: Cerebral hemorrhage -- Pregnancy -- Craniotomy -- Neurosurgical procedures -- Anesthesia; Hemorragia cerebral -- Embarazo -- Craneotomia -- Procedmientos neuroquirúrgicos -- Anestesia; Anesthesiology -- Periodicals; Anesthesiology -- Colombia -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology; Colombia; Periodicals
• Languages: English
• ISSNs: 2256-2087

Abstract

Abstract : 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. Abstract : RESUMEN : La hemorragia intracraneana (HIC) es la tercera causa indirecta no obstétrica de muerte materna. Describimos el manejo anestésico de una mujer de 32 años con 22 semanas de gestación, quien presentó hemorragia intracraneana debida a la ruptura de una malformación arteriovenosa (MAV). Para el manejo de esta clase de pacientes se requiere un enfoque complejo con un plan altamente individualizado en el que participen neurocirujanos, neurorradiólogos, anestesiólogos, obstetras y neonatólogos a fin de evaluar los riesgos y los beneficios de las diferentes alternativas terapéuticas. Considerando el riesgo elevado de sangrado ulterior durante el embarazo y la localización de la MAV, se consideró que la mejor alternativa terapéutica en este caso era la craneotomía para extirpar por completo la lesión.