Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.

Hdl Handle:
http://hdl.handle.net/10147/207709
Title:
Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.
Authors:
Tadrous, R; Ni Mhuirchteagh, R; McCaul, C
Affiliation:
Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland.
Citation:
Int J Obstet Anesth. 2011 Jul;20(3):259-62. Epub 2011 Feb 18.
Journal:
International journal of obstetric anesthesia
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207709
DOI:
10.1016/j.ijoa.2010.11.011
PubMed ID:
21315576
Abstract:
Sturge-Weber syndrome consists of facial capillary malformation (port-wine stain) and abnormal blood vessels in the brain or eye. Seizures, developmental delay and intracranial and airway angiomata are principal concerns. We report a 28-year-old primiparous woman at 41 weeks of gestation with Sturge-Weber syndrome who developed unilateral weakness, aphasia, blurred vision and confusion. Preeclampsia was excluded. Neuroimaging showed left sided cerebral oedema and a right parieto-occipital lesion, most likely an angioma. Caesarean section was planned to avoid the risk of angioma rupture during labour. General anesthesia was avoided due to the haemodynamic response to laryngoscopy and reports of seizure-related mortality. Despite the possibility of raised intracranial pressure and precipitation of cerebral herniation, a lumbar epidural block was administered but failed. A subarachnoid block was successfully performed and a healthy infant delivered. The choice of anaesthesia was strongly influenced by detailed radiological investigations and multidisciplinary participation.
Language:
eng
MeSH:
Adult; Anesthesia, Epidural; *Anesthesia, Obstetrical; Brain/pathology; Cesarean Section/*methods; Female; Humans; Infant, Newborn; Magnetic Resonance Imaging; Nervous System Diseases/*etiology/therapy; Pregnancy; Sturge-Weber Syndrome/*complications/diagnosis; Treatment Failure
ISSN:
1532-3374 (Electronic); 0959-289X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorTadrous, Ren_GB
dc.contributor.authorNi Mhuirchteagh, Ren_GB
dc.contributor.authorMcCaul, Cen_GB
dc.date.accessioned2012-02-01T10:37:39Z-
dc.date.available2012-02-01T10:37:39Z-
dc.date.issued2012-02-01T10:37:39Z-
dc.identifier.citationInt J Obstet Anesth. 2011 Jul;20(3):259-62. Epub 2011 Feb 18.en_GB
dc.identifier.issn1532-3374 (Electronic)en_GB
dc.identifier.issn0959-289X (Linking)en_GB
dc.identifier.pmid21315576en_GB
dc.identifier.doi10.1016/j.ijoa.2010.11.011en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207709-
dc.description.abstractSturge-Weber syndrome consists of facial capillary malformation (port-wine stain) and abnormal blood vessels in the brain or eye. Seizures, developmental delay and intracranial and airway angiomata are principal concerns. We report a 28-year-old primiparous woman at 41 weeks of gestation with Sturge-Weber syndrome who developed unilateral weakness, aphasia, blurred vision and confusion. Preeclampsia was excluded. Neuroimaging showed left sided cerebral oedema and a right parieto-occipital lesion, most likely an angioma. Caesarean section was planned to avoid the risk of angioma rupture during labour. General anesthesia was avoided due to the haemodynamic response to laryngoscopy and reports of seizure-related mortality. Despite the possibility of raised intracranial pressure and precipitation of cerebral herniation, a lumbar epidural block was administered but failed. A subarachnoid block was successfully performed and a healthy infant delivered. The choice of anaesthesia was strongly influenced by detailed radiological investigations and multidisciplinary participation.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnesthesia, Epiduralen_GB
dc.subject.mesh*Anesthesia, Obstetricalen_GB
dc.subject.meshBrain/pathologyen_GB
dc.subject.meshCesarean Section/*methodsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshMagnetic Resonance Imagingen_GB
dc.subject.meshNervous System Diseases/*etiology/therapyen_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshSturge-Weber Syndrome/*complications/diagnosisen_GB
dc.subject.meshTreatment Failureen_GB
dc.titleAnaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.en_GB
dc.contributor.departmentDepartment of Anaesthesia, The Rotunda Hospital, Dublin, Ireland.en_GB
dc.identifier.journalInternational journal of obstetric anesthesiaen_GB
dc.description.provinceLeinster-

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