Spontaneous subdural hematoma associated with preeclampsia: a case report and litterature review

Oudghiri, Nezha; Behat, M.; Elchhab, Nada; Doumiri, Mouhssine; Tazi, Anas Saoud

doi:10.11604/pamj.2014.19.213.5451

Cited by 6 publications

(8 citation statements)

References 4 publications

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“… 14 , 16 , 21 Bateman et al demonstrated that GH (odds ratio [OR] 2.41, 95% CI 1.62–3.59) and preeclampsia/eclampsia (OR 10.39, 95% CI 8.32–12.98) were independent predictors of pregnancy-related intracerebral hemorrhage. 15 Although the ICH associated with preeclampsia is typically intraparenchymal, subdural hematomas or subarachnoid hemorrhages have also been observed, 19 , 21 , 26 including our study. However, most studies followed patients for only 6 weeks after delivery.…”

Section: Discussionmentioning

confidence: 46%

“… 12 In a study by Bateman et al, 15 GH and preeclampsia/eclampsia were significant independent risk factors for ICH during pregnancy, and accounted for 30.5% of such cases. In a study by Oudghiri et al, 19 a patient with preeclampsia at 31 weeks of gestation developed a spontaneous subdural hematoma. However, few studies have investigated the relationship between PIH and long-term ICH risk.…”

Section: Introductionmentioning

confidence: 99%

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Increased Risk of Intracranial Hemorrhage in Patients With Pregnancy-Induced Hypertension

Lin

Tsui

Cheng³

et al. 2016

Medicine

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Pregnancy-induced hypertension (PIH) may be a major predictor of pregnancy-associated intracranial hemorrhage (ICH). However, the relationship between PIH and long-term ICH risk is unknown.The objective of the study was to determine the association between PIH and ICH and to identify the predictive risk factors.Patients with newly diagnosed PIH were recruited from the Taiwan National Health Insurance Research Database. PIH patients were divided into gestational hypertension (GH) and preeclampsia groups. The 2 groups were separately compared with matched cohorts of patients without PIH based on age and date of delivery. The occurrence of ICH was evaluated in both cohorts. The overall observational period was from January 1, 2000 to December 31, 2013.Among the 23.3 million individuals registered in the National Health Insurance Research Database, 28,346 PIH patients, including 7390 with GH and 20,956 with preeclampsia, were identified. The incidences of ICH were increased in both groups (incidence rate ratio [IRR] = 3.72 in the GH group, 95% confidence interval [CI] 3.63–3.81, P < 0.0001 and IRR = 8.21 in the preeclampsia group, 95% CI 8.12–8.31, P < 0.0001, respectively). In addition, according to the results of stratification of follow-up years, both groups were associated with a highest risk of ICH at 1 to 5 years of follow-up (IRR = 11.99, 95% CI 11.16–12.88, P < 0.0001 and IRR = 21.83, 95% CI 21.24–22.44, P < 0.0001, respectively). After adjusting for age, parity, severity of PIH, number of PIH occurrences, gestational age, and comorbidities in the multivariate survival analysis using Cox regression model, age ≥30 years (hazard ratio [HR] 1.99, 95% CI 1.27–3.10, P = 0.0026), patients with preeclampsia (HR 2.18, 95% CI 1.22–3.90, P = 0.0089), multiple PIH occurrences (HR 4.08, 95% CI 1.85–9.01, P = 0.0005), hypertension (HR 4.51, 95% CI 1.89–10.74, P = 0.0007), and obesity (HR 7.21, 95% CI 1.58–32.84, P = 0.0107) were independent risk factors for the development of ICH among patients with PIH.Patients with PIH, especially those with older age, preeclampsia, and multiple PIH occurrences, may have an increased risk of developing ICH later in life.

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Section: Discussionmentioning

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Increased Risk of Intracranial Hemorrhage in Patients With Pregnancy-Induced Hypertension

Lin

Tsui

Cheng³

et al. 2016

Medicine

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“…She denied any recent trauma and did not have any apparent risk factors to explain the bleeding. Based on limited case reports, many non‐traumatic SDHs during pregnancy occur in the setting of hypertension with or without preeclampsia 1,2,4 . In these cases, increased intracranial pressure as well as associated thrombocytopenia or coagulation abnormalities may contribute to bleeding risk.…”

Section: Discussionmentioning

confidence: 99%

“…While intracranial hemorrhage is uncommon during pregnancy, it is a severe and sometimes fatal complication that contributes to maternal mortality and morbidity around the world. The most likely etiologies are ruptured aneurysms, hypertension, and trauma 1 . When it comes to subdural hematomas (SDH) in particular, these are most commonly due to trauma causing rupture of the bridging veins, though the incidence of such injuries in pregnancy remains low.…”

Section: Introductionmentioning

confidence: 99%

A multidisciplinary approach to management of a non‐traumatic subdural hematoma in the third trimester of pregnancy: A case report and review of literature

Lugata,

Smith,

Mrosso

et al. 2024

Clinical Case Reports

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Key MessageAlthough non‐traumatic SDHs are uncommon during and immediately following pregnancy, management of these cases should be carried out by a multidisciplinary team, including obstetricians, pediatricians, neurosurgeons, and anesthesiologists.AbstractIntracranial hemorrhage represents an uncommon but serious complication of pregnancy. Non‐traumatic subdural hematomas (SDH) are uncommon during the prenatal period with limited literature about etiology and management. In this case report, the authors report on a patient with non‐traumatic SDH in the third trimester of pregnancy. The patient is a 40‐year‐old G6P5L5 female at gestational age of 34 weeks and 5 days presenting with frontal headache, nausea, vomiting, and blurry vision. CT scan revealed an acute on chronic right subdural hematoma with midline shift and multiple herniations. An emergency cesarean section and right burr hole SDH evacuation were performed. Etiology of the SDH remains unknown. Although non‐traumatic SDHs are uncommon during and immediately following pregnancy, health care providers should always consider this possibility if a patient presents with typical symptoms and signs. Management of these cases should be carried out by a multidisciplinary team, including obstetricians, pediatricians, neurosurgeons, and anesthesiologists to optimize maternal and fetal outcomes.

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“…Por persistencia de la sintomatología, aparición de disartria y disminución de la fuerza muscular en el hemicuerpo derecho acude a nuestra institución 16 Se diagnostica preeclampsia severa y se inicia manejo con labetalol en bolo, sulfato de magnesio y antihipertensivos orales. Se interrumpe el embarazo mediante cesárea de urgencia.…”

Section: Caso Clínicounclassified

Hemorragia intracraneal asociada a preeclampsia severa

Cogollo

2016

Rev. chil. obstet. ginecol.

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RESUMENLa hemorragia intracraneal constituye una patología poco frecuente del embarazo y asociada a pobres resultados materno-fetales. Dentro de sus causas se encuentra, la preeclampsia severa, la cual aumenta la mortalidad en estas pacientes. Se presenta el caso de una gestante que acude al servicio de urgencias con síntomas neurológicos e hipertensión arterial, diagnosticándose preeclampsia severa, con realización de cesárea de urgencia. La tomografía de cráneo mostró hemorragia temporal izquierda, requiriendo manejo en cuidados intensivos con posterior estabilización y alta médica. La hemorragia intracraneal requiere un alto índice de sospecha, monitoreo intensivo y manejo multidisciplinario. PALABRAS CLAVE: Ictus, hemorragia cerebral, preeclampsia SUMMARYIntracranial hemorrhage is a rare complication during pregnancy, it is associated with poor maternal and fetal outcomes. Cerebral haemorrhage caused by pre-eclampsia increases mortality in these patients. We present the case of a pregnant woman who consulted to the service of urgencies with neurological symptoms and hypertension. Severe preeclampsia was diagnosed. She underwent successful emergent cesarean section. The brain scan showed a left temporal hemorrhage. She required intensive care management with subsequent stabilization and discharged from the hospital. Intracranial hemorrhage requires a high index of suspicion, intensive monitoring, and a multidisciplinary approach. KEY WORDS: Stroke, intracranial hemorrhage, preeclampsia INTRODUCCIÓNLa hemorragia intracraneal (HIC) durante la gestación, se presenta alrededor de 4,3 a 8 casos/100.000 embarazos (1,2) y está asociada a pobres resultados materno-fetales. Las principales causas son: anomalías vasculares, preeclampsia/ eclampsia, coagulopatía e idiopática (3). La mortalidad materna oscila entre el 18 -38% (1,2,4) y se relaciona con secuelas neurológicas permanentes en los sobrevivientes (4). Los factores asociados a mortalidad son la preeclampsia y la demora de más de 3 horas en el diagnóstico (4). Por eso, la importancia de realizar un diagnóstico oportuno para impactar en el pronóstico.Presentamos el caso de una paciente, que acude al servicio de urgencias 16 horas después del inicio de la sintomatología, con preeclampsia severa más hemorragia temporal izquierda. REV CHIL OBSTET GINECOL 2016; 81(6): 511 -514

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Spontaneous subdural hematoma associated with preeclampsia: a case report and litterature review

Cited by 6 publications

References 4 publications

Increased Risk of Intracranial Hemorrhage in Patients With Pregnancy-Induced Hypertension

Increased Risk of Intracranial Hemorrhage in Patients With Pregnancy-Induced Hypertension

A multidisciplinary approach to management of a non‐traumatic subdural hematoma in the third trimester of pregnancy: A case report and review of literature

Hemorragia intracraneal asociada a preeclampsia severa

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