[A case of dural AVM during pregnancy (author's transl)]

A case of dural AVM manifested during pregnancy was reported. On December 28, 1979, a 28-year-old primipara, suddenly developed headache, nausea and vomiting at the 8th month of her pregnancy and soon after became unconscious. She was transferred by ambulance to our hospital. On admission she was comatose exhibiting decerebrate rigidity. The blood pressure was 126/76 mmHg and the pulse rate 97 per minute and regular. Right pupil was dilated and did not react to light. CT scan revealed a subdural hematoma on the right side and intracerebral hematoma in the right middle fossa. Angiography demonstrated a dural AVM in the right anterior middle fossa fed by the middle meningeal artery. Venous drainage consisted of the superficial sylvian vein directed toward the superior sagittal sinus. The patient was in no good condition, so we only removed subdural hematoma, decompressed externally and ligated the external carotid artery. The postoperative course was uneventful, the anisocoria was diminished, and the consciousness improved up to confusion, but the right hemiparesis remained. Two months later a 2,760g baby girl was born by Caesarean section without accident. But two weeks later, suddenly she had generalized convulsions and became comatose. CT scan revealed an intracerebral hematoma in the middle fossa again. Second operation was performed, and the nidus was electrocoagulated and removed together with the hematoma. The postoperative course was also uneventful. At present, one and a half years after operation, no symptom of recurrence is observed. Intracerebral hemorrhage and dural AVM in pregnancy were discussed and the reports in the literature were reviewed.