Title: Anesthetic Management of a Pregnant Patient with CSVT for Emergency LSCS and Craniotomy

Authors: Dr Naresh.V, Dr Sudhakar. L, Dr Chandra Sekhar C.N.

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.97

Abstract

Cerebral sinus venous thrombosis is a rare phenomenon seen in pregnant woman and one of the major causes of stroke with high mortality. Cerebral venous thrombosis with intracranial hemorrhage has a poor outcome than with CSVT alone. Here, we report a case of a 27 year old female primi-gravida with 32 weeks of gestational age diagnosed as CSVT with hemorrhage, underwent LSCS followed by craniotomy in the same setting, managed successfully.

Keywords: CSVT, CVT, Pregnancy, LSCS, Craniectomy.

References

  1. Grear K.E, Bushnell, C.D . Stroke and pregnancy: Clinical presentation, evaluation, treatment and epidemiology. Clin Obstet Gynaecol. 2013; 56(2): 350 -359.
  2. Jaigobin C, Silver FL. Stroke and pregnancy. 2000; 31:2948–51.
  3. Le LT, Wendling A. Anesthetic management for cesarean section in a patient with rupture of a cerebellar arteriovenous malformation. J Clin Anesth. 2009 Mar ;21(2):143-8.
  4. Lapinsky SE, Rojas-Suarez JA,  Crozier TM, Vasquez DN, Barrett N, Austin K, et al. Mechanical ventilation in critically-ill pregnant women: a case series. Int J Obstet Anesth. 2015 Nov; 24(4):323-8.
  5. Subramanian R, Sardar A, Mohanaselvi S, Khanna P, Baidya DK. Neurosurgery and pregnancy. J Neuroanaesthesiol Crit Care 2014;1:166-72.
  6. Kazuyoshi Aoyama, P Gareth Seaward and Stephen E Lapinsky. Fetal outcome in the critically ill pregnant woman. Crit Care. 2014; 18(3): 307.
  7. Wang LP, Paech MJ. Neuroanesthesia for the pregnant woman. Anesth Analg. 2008 Jul;107(1):193-200.
  8. Yoo KY, Lee JC,  Yoon MH,  Shin MH,  Kim SJ,  Kim YH, et al. The effects of volatile anesthetics on spontaneous contractility of isolated human pregnant uterine muscle: a comparison among sevoflurane, desflurane, isoflurane, and halothane. Anesth Analg. 2006 Aug;103(2):443-7.
  9. Yildiz K, Dogru K, Dalgic H, Serin IS, Sezer Z, Madenoglu H, et al. Inhibitory effects of desflurane and sevoflurane on oxytocin-induced contractions of isolated pregnant human myometrium. Acta Anaesthesiol Scand. 2005 Oct; 49(9):1355-9.
  10. Bisri DY, Wullur C, Bisri T. Anaesthetic management for combined emergency caesarean section and craniotomy tumour removal.  J Neuroanaesthesiol Crit Care. 2017; 4:53-6.
  11. Khurana, T, Taneja, B, & Saxena K. N. Anesthetic management of a parturient with glioma brain for caesarean section immediately followed by craniotomy. J Anaesthesiol  Clin Pharmacol. 2014. jul – Sep. 30(3), 397–399.

Corresponding Author

Dr Naresh.V

Department of Anaesthesiology and Pain Medicine

Yashoda Hospital, Somajiguda, Hyderabad