Anesthetic management of labor and delivery in patients with elevated intracranial pressure

Anson, Jonathan; Vaida, Sonia; Giampetro, David; McQuillan, Patrick

doi:10.1016/j.ijoa.2015.01.004

Cited by 22 publications

(6 citation statements)

References 128 publications

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“…The apparent increase in vascular resistance may reflect a healthy cerebrovascular response to the normal changes in cardiac output after delivery, as homeostasis is reestablished through a rise in systemic vascular resistance to prepregnancy levels. The lack of postpartum change in the mean ONSD in this and another study is not surprising, as healthy pregnancy is not thought to alter the intracranial pressure …”

Section: Discussionmentioning

confidence: 45%

“…The lack of postpartum change in the mean ONSD in this and another study 15 is not surprising, as healthy pregnancy is not thought to alter the intracranial pressure. 56 Interobserver and intraobserver reliability relates to the reproducibility of the examination itself, whereas interreader and intrareader reliability relates to the post hoc interpretation of stored ultrasound images. The former has been found by other authors to be high for both Doppler variables of the ophthalmic artery 21,57 and dimensions of the optic nerve sheath.…”

Section: The Absence Of a Clear Relationship Between Ophthalmic Arterymentioning

confidence: 99%

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Optic nerve sonography and ophthalmic artery Doppler velocimetry in healthy pregnant women: an Australian cohort study

Kane

Dennis

Costa

et al. 2019

J of Clinical Ultrasound

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Purpose Maternal ocular sonography offers a window into cerebrovascular and intracranial pressure changes in pregnancy. This study aimed to determine the Doppler velocimetric variables of the ophthalmic artery, and the mean diameter of the optic nerve sheath (ONSD), in an Australian cohort of healthy pregnant women. Methods A prospective observational cohort study of healthy women with uncomplicated singleton pregnancies in the third trimester was undertaken in a tertiary maternity service. A single prenatal ultrasonographic examination was performed on all participants, with a postnatal examination performed on a subgroup with uncomplicated deliveries. Results Fifty women were examined at a mean gestation of 35 weeks. The mean ± SD Doppler variables in the ophthalmic artery were peak systolic velocity (PSV) 41.89 ± 13.13 cm/s, second peak velocity 20.63 ± 8.97 cm/s, end diastolic velocity 9.29 ± 5.13 cm/s, pulsatility index 1.97 ± 0.53, resistive index 0.78 ± 0.07, peak ratio (second peak velocity/PSV) 0.49 ± 0.12, while the mean ONSD was 4.34 ± 0.4 mm. None of these variables had a demonstrable relationship with gestation or mean arterial pressure (MAP), nor did the sheath diameter have a relationship with any of the Doppler variables. Conclusions The ocular sonographic variables observed in this population are similar to those reported in other cohorts. No clear relationship could be identified in this cohort between ophthalmic artery Doppler variables and the ONSD, and between each of these variables and gestation or MAP.

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Section: Discussionmentioning

confidence: 45%

Section: The Absence Of a Clear Relationship Between Ophthalmic Arterymentioning

confidence: 99%

Optic nerve sonography and ophthalmic artery Doppler velocimetry in healthy pregnant women: an Australian cohort study

Kane

Dennis

Costa

et al. 2019

J of Clinical Ultrasound

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“…The anesthetic choice for IIH patients is complex and depends on balancing the risks and benefits of each available technique. 16 , 17 Although neuraxial anesthesia is contraindicated in patients with intracranial hypertension resulting from space occupying lesions due the risk of uncal herniation, in IIH patients there is a uniform swelling of the brain that prevents herniation, so neuraxial anesthesia can be used safely. 1 , 16 , 18 , 19 Spinal anesthesia will increase the volume of fluid in the subarachnoid space and epidural anesthesia will compress the dural sac, altering the compliance of spinal subarachnoid space.…”

Section: Anesthetic Considerationsmentioning

confidence: 99%

Multidisciplinary management of idiopathic intracranial hypertension in pregnancy: case series and narrative review

Alves

Sousa

Cardoso

et al. 2022

Brazilian Journal of Anesthesiology (English Edition)

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“…Causes which may rise ICP and sudden hypotension should be avoided. The selection of anesthesia for patients with IIH is not straightforward and is based on a risk-benefit analysis of each technique that is available [17, 18].…”

Section: Discussionmentioning

confidence: 99%

Anesthesia Management of a Pregnant Patient with Idiopathic Intracranial Hypertension and Sepsis Who Needs Emergency Cesarean Section: A Case Report

Hashey¹

2023

Dubai Med J

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Idiopathic intracranial hypertension (IIH) is a rare neurological disorder, characterized by raising intracranial pressure of unknown reason, increased cerebrospinal fluid pressure without changes in its composition, and usually it is presented by headache, papilledema. In this report, we will discuss the anesthesia management of cesarean section for a 31-year-old, morbidly obese patient (body mass index = 42 kg/m<sup>2</sup>), pregnant at 37 weeks, with IIH along with sepsis.

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Anesthetic management of labor and delivery in patients with elevated intracranial pressure

Cited by 22 publications

References 128 publications

Optic nerve sonography and ophthalmic artery Doppler velocimetry in healthy pregnant women: an Australian cohort study

Optic nerve sonography and ophthalmic artery Doppler velocimetry in healthy pregnant women: an Australian cohort study

Multidisciplinary management of idiopathic intracranial hypertension in pregnancy: case series and narrative review

Anesthesia Management of a Pregnant Patient with Idiopathic Intracranial Hypertension and Sepsis Who Needs Emergency Cesarean Section: A Case Report

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