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Pregnancy and intracranial aneurysms
M A Stoodley1, R L Macdonald, B K Weir
1Section of Neurosurgery, Pritzker School of Medicine, University of Chicago, Illinois, USA.
Neurosurgery Clinics of North America
|July 21, 1998
Summary
Pregnancy increases the risk of aneurysmal subarachnoid hemorrhage, a rare but serious maternal mortality cause. Prompt neurosurgical intervention is crucial for ruptured aneurysms, prioritizing maternal safety.
Area of Science:
- Neurology
- Neurosurgery
- Obstetrics
Background:
- Aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy is infrequent but significantly contributes to maternal mortality.
- Pregnancy-related physiological changes may increase the likelihood of cerebral aneurysm development and rupture.
- Management decisions for pregnant patients with aSAH require careful consideration of both neurosurgical and obstetric factors.
Purpose of the Study:
- To outline the management principles for aneurysmal subarachnoid hemorrhage in pregnant patients.
- To emphasize the precedence of neurosurgical over obstetric considerations in cases of aSAH during pregnancy.
- To provide guidance on the treatment of both ruptured and unruptured aneurysms in pregnant individuals.
Main Methods:
- Review of existing literature and clinical guidelines regarding aSAH in pregnancy.
- Analysis of neurosurgical and obstetric management strategies.
- Case-based discussion of treatment decisions for ruptured and unruptured aneurysms.
Main Results:
- Neurosurgical management generally takes priority over obstetric concerns in aSAH during pregnancy.
- Ruptured aneurysms in pregnant patients require immediate treatment, similar to non-pregnant individuals.
- Treatment for unruptured aneurysms is indicated if symptomatic or enlarging; otherwise, it is individualized.
Conclusions:
- Prompt and appropriate neurosurgical intervention is paramount for managing aSAH in pregnant women.
- The management approach for aSAH in pregnancy should prioritize maternal survival and neurological outcome.
- Individualized treatment strategies are essential for unruptured aneurysms during pregnancy.