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Related Experiment Videos

[Cerebral aneurysms and pregnancy: 4 cases].

S Depret-Mosser1, J C Monnier, A S Bouthors-Ducloy

  • 1Service de Gynécologie-Obstétrique, Maternité du Pavillon Victor-Olivier, CHU, Lille.

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|January 1, 1992
PubMed
Summary

Pregnancy increases the risk of cerebral aneurysms rupturing, leading to haemorrhagic cerebral accidents, particularly in first-time mothers during the third trimester. Prompt neurosurgical intervention is crucial to prevent recurrent bleeding and ischaemia.

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Area of Science:

  • Neurosurgery
  • Obstetrics
  • Vascular Neurology

Background:

  • Haemorrhagic cerebral accidents are the most frequent neurosurgical conditions during pregnancy.
  • Pregnancy elevates the risk of arterial or arteriovenous aneurysm rupture, the primary cause of these haemorrhages.
  • These events predominantly affect primiparae in the third trimester.

Observation:

  • Diagnosis is confirmed through scanning and angiography.
  • Eclampsia is the primary differential diagnosis.
  • Immediate neurosurgical treatment is recommended to mitigate risks of re-bleeding and ischaemia.

Findings:

  • Caesarean section is indicated only in specific severe maternal conditions or when the fetus is viable and the vascular malformation poses significant risks.

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  • Vaginal delivery is generally preferred under epidural anaesthesia, especially if medical induction or instrumental delivery is necessary.
  • Prognosis is often poor, contingent upon the initial neurosurgical severity, lesion etiology, and treatment efficacy.

    • Implications:

    • Optimal management necessitates a multidisciplinary approach involving neurosurgical and obstetric teams.
    • Timely intervention can improve outcomes for both mother and child in cases of pregnancy-related cerebral haemorrhage.
    • Further research into preventative strategies and refined treatment protocols for pregnant patients with cerebral vascular abnormalities is warranted.