Rupture of cerebral aneurysm during pregnancy: a case report

Abstract

Hamilelik döneminde ve puerperium boyunca subaraknoid kanamanın en sık nedeni intrakraniyal anevrizma rüptürüdür. Gebe kadınlarda gebe olmayan kadınlara göre beş kat daha sık görülür. Primipar gebelerde ve gebeliğin 3. trimesterinde görülme oranı daha yüksektir. Ani başlayan baş ağrısı ve bilinç kaybı ile acil servise başvuran 37 yaşında, 34 haftalık gebeye orta serebral arter anevrizması rüptürüne bağlı intrakraniyal kanama tanısı konuldu. Acil sezaryen ile doğum yaptırılan hasta subaraknoid kanama nedeniyle opere edilmiştir. Hasta nadir görülen bir olgu olması nedeniyle sunulmuştur.

Pregnancy complicated by neurological and neurosurgical conditions – The evidence regarding mode of delivery

“…15,23,25,26 Where aneurysmal haemorrhage occurs in early pregnancy, VD may occur after clipping or embolisation has been performed. 27…”

Awake endovascular coiling of a dissected intracranial aneurysm in a third-trimester twin pregnancy

“…Intracranial aneurysms in pregnancy are very rare and have been reported in all child bearing age groups but predominantly in pregnant women who are about 30 years and older. [ 2 , 4 – 6 , 10 , 11 ] Pregnancy-related aneurysmal rupture occurs in about 50% of women under the age of 40 years. [ 12 , 13 ] Although aneurysmal rupture in pregnancy has been reported in all the trimesters, most of them were detected in the third trimester.…”

“…[ 1 , 2 , 5 , 14 , 18 ] Nevertheless, the primary differential diagnosis of aneurysmal SAH includes, eclampsia, meningitis, encephalitis, pituitary apoplexy, dural sinus thrombosis, ischemic stroke, intracranial tumors, as well as demyelinating diseases. [ 8 , 9 , 11 ]…”

“…CT and MRI are the initial radiological modalities in evaluating cerebral lesions in pregnant women. [ 5 , 9 , 11 , 19 ] Nevertheless, cerebral angiogram is the criterion standard radiological modality for detecting intracranial aneurysms. [ 1 , 9 ] The exposure of fetus to radiation is usually the main concern during radiological imaging in pregnancy.…”

A Case Report of Spontaneous Vaginal Delivery Under General Anesthesia in a Patient With a Large Cerebral Aneurysm

“…CS has not been shown to have superior maternal and fetal outcomes compared to vaginal delivery [2]. However, severe circumstances where CS would be indicated include maternal coma, brainstem damage, and aneurysm diagnosis at the time of labor [7]. Decisions regarding the mode of delivery should be based on obstetric considerations and shared decision-making.…”