Epidural Anesthesia for Cesarean Section in a Patient with cerebral vascular disease

Abstract

Cerebrovascular disease is relatively rare in women of childbearing age, but women do present for peripartummanagement with a variety of other vascular disorders. Moyamoya disease is a rare progressive occlusive disease of thecircle of Willis and the proximal intracranial vessels. We report the anesthetic management of a 28-year-old femalepatient with moyamoya disease using epidural anesthesia for a cesarean section. Epidural anesthesia was performedusing endtidal carbon dioxide level monitoring in order to avoid hyperventilation that may induce ischemic attacks inmoyamoya patients. The patient was kept stable hemodynamically and there was no postoperative pain, and nopostoperative neurological defects.