Neurosurgical procedures in pregnancy

Çırak, Bayram; Kıymaz, Nejmi; Kerman, Memduh; Tahta, Kadir

doi:10.1590/s0102-86502003000100002

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…Small sample size and relatively limited period of follow-up were our major obstacles. Further prospective studies are needed to elucidate the safety of endovascular versus microsurgical management during pregnancy over a longer follow up periods, especially in context of embolization with non-adhesive embolic agents, such as Onyx [81][82][83][84][85][86]. …”

Section: Resultsmentioning

confidence: 99%

Cranial Arteriovenous Malformations During Pregnancy: A Multidisciplinary Algorithm for Safe Management. Case Series and Review of the Literature

Mohamed¹,

Sultan²,

Tamer³

et al. 2016

JNSK

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Submit Manuscript | http://medcraveonline.com IntroductionBrain Arteriovenous malformations (AVM) are abnormal communication between parts of cranial arterial and venous systems with the lack of a true nutritive and absorptive capillary bed [1]. The universal prevalence of AVM is relatively uncommon, with a prevalence ranging from 0.01-0.5%, 10/100000 to 140-500/100000 specifically [2][3][4][5][6][7] clustering between 3 rd and 5 th decade i.e. presenting usually before 40 years old of age [4,8,9]. AVM commonly presents with hemorrhage in more than one half of the cases even during pregnancy [4,8,[10][11][12][13][14][15][16][17] AbstractBackground: Cerebral arteriovenous malformations (AVMs) are relatively uncommon lesions in general population and rare among pregnant females, meanwhile they carry a relatively higher morbidity and mortality. In view of limited data for optimal management, we try to address dilemmas commonly encountered in pregnant females with cranial AVM and propose multidisciplinary algorithms for safe management.

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Section: Resultsmentioning

confidence: 99%

Cranial Arteriovenous Malformations During Pregnancy: A Multidisciplinary Algorithm for Safe Management. Case Series and Review of the Literature

Mohamed¹,

Sultan²,

Tamer³

et al. 2016

JNSK

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“…The main objective of action in the field of neurosurgery is to maintain maternal and fetal survival. [ 9 40 ] The action was carried out with the aim of preventing the occurrence of fetal asphyxia, preventing prolonged exposure to the use of drugs that are teratogenic, and preventing preterm labor. [ 41 ] Timing of surgery is a big challenge for neurosurgeons and obstetricians [Tables 5 and 6 ].…”

Section: Discussionmentioning

confidence: 99%

Algorithm of traumatic brain injury in pregnancy (Perspective on neurosurgery)

et al. 2021

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Background: The maternal deaths due to obstetrical cases declined, but the maternal deaths that caused by nonobstetrical cases still increase. The study reported that traumatic cases in pregnancy are the highest causes of mortality in pregnancy (nonobstetrical cases) in the United States. Another study reported that 1 in 12 pregnant women that experienced traumatic accident and as many as 9.1% of the trauma cases were caused by traumatic brain injury (TBI). The female sex hormone has an important role that regulates the hemodynamic condition. Anatomical and physiological changes during pregnancy make the examination, diagnosis, and treatment of TBI different from non-pregnant cases. Therefore, it is very important to lead the algorithm for each institution based on their own resources. Case Series: A 37-year-old woman with a history of loss of consciousness after traffic accident. She rode a motorbike then hit the car. She was referred at 18 weeks' gestation. Glasgow Coma Scale (GCS) E 1 V 1 M 4 , isochoric of the pupil, reactive to the light reflex, and right-sided hemiparesis. The non-contrast head computed tomography (CT) scan revealed subdural hematoma (SDH) in the left frontal-temporal-parietal region, SDH of the tentorial region, burst lobe intracerebral hemorrhage, and cerebral edema. There was not a fetal distress condition. The next case, a 31 years old woman, in 26 weeks gestation, had a history of unconscious after motorcycle accident then she fell from the height down to the field about 3 m. GCS E 1 V 1 M 3 , isochoric of the pupil, but the pupil reflex decreased. Noncontrast CT scan revealed multiple contusion, subarachnoid hemorrhage, and cerebral edema. She had a good fetal condition. Discussion: We proposed the algorithm of TBI in pregnancy that we already used in our hospital. The main principle of the initial management must be resuscitating the mother and that also the maternal resuscitation. The primary and secondary survey is always prominent of the initial treatment. Conclusion: The clinical decision depends on the condition of the fetal, the surgical lesion of the intracranial, and also the resources of the neonatal intensive care unit in our hospital.

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“…in a stable patient, induction of vaginal delivery is permitted 8 . A shortened second stage can be achieved with epidural anaesthesia 9 .…”

Section: Discussionmentioning

confidence: 99%

A case series discussing the anaesthetic management of pregnant patients with brain tumours

et al. 2013

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Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours. This is a retrospective study. Information on pregnant patients diagnosed with brain tumours that underwent caesarean section (CS) and/or brain tumour resection from May 2003 through June 2008 was obtained from the Department of General Anaesthesia and the Rose Ella Burkhardt Brain Tumour & Neuro-Oncology Centre (BBTC) at the Cleveland Clinic, OH, USA. The mean age was 34.5 years (range 29-40 years old). Six patients had glioma, two of whom had concomitant craniotomy and CS. Six cases had the tumour in the frontal lobe. Four cases were operated on under general anaesthesia and three underwent awake craniotomy. The neonatal outcomes of the six patients with elective or emergent delivery were six viable infants with normal Apgar scores. Pregnancy was terminated in the 7th patient. In conclusion, management of brain tumours in pregnant women is mainly reliant on case reports and the doctor's personal experience. Therefore, close communication between the neurosurgeon, neuroanaesthetist, obstetrician and the patient is crucial. General anaesthesia, propofol, dexmedetomidine and remifentanil were used in our study and were safe. Although this may not agree with previous studies, desflurane and isoflurane were used in our patients with no detectable complications.

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Neurosurgical procedures in pregnancy

Cited by 12 publications

References 14 publications

Cranial Arteriovenous Malformations During Pregnancy: A Multidisciplinary Algorithm for Safe Management. Case Series and Review of the Literature

Cranial Arteriovenous Malformations During Pregnancy: A Multidisciplinary Algorithm for Safe Management. Case Series and Review of the Literature

Algorithm of traumatic brain injury in pregnancy (Perspective on neurosurgery)

A case series discussing the anaesthetic management of pregnant patients with brain tumours

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