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

Hdl Handle:
http://hdl.handle.net/10147/208152
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:
Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration. 2011, 20 (3):259-62 Int J Obstet Anesth
Publisher:
Elsevier
Journal:
International journal of obstetric anesthesia
Issue Date:
Jul-2011
URI:
http://hdl.handle.net/10147/208152
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.
Item Type:
Article In Press
Language:
en
Description:
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.
Keywords:
Adult; Anaesthesia, Epidural; Anaesthesia , Obstetrical; Brain, Pathology; Caesarean Section/methods; Female
MeSH:
Adult; Anesthesia, Epidural; Anesthesia, Obstetrical; Brain; Cesarean Section; Female; Humans; Infant, Newborn; Magnetic Resonance Imaging; Nervous System Diseases; Pregnancy; Sturge-Weber Syndrome; Treatment Failure
ISSN:
1532-3374

Full metadata record

DC FieldValue Language
dc.contributor.authorTadrous, Ren
dc.contributor.authorNi Mhuirchteagh, Ren
dc.contributor.authorMcCaul, Cen
dc.date.accessioned2012-02-01T14:30:08Z-
dc.date.available2012-02-01T14:30:08Z-
dc.date.issued2011-07-
dc.identifier.citationAnaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration. 2011, 20 (3):259-62 Int J Obstet Anesthen
dc.identifier.issn1532-3374-
dc.identifier.pmid21315576-
dc.identifier.doi10.1016/j.ijoa.2010.11.011-
dc.identifier.urihttp://hdl.handle.net/10147/208152-
dc.descriptionAbstract 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.en
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.-
dc.language.isoenen
dc.publisherElsevieren
dc.subjectAdulten
dc.subjectAnaesthesia, Epiduralen
dc.subjectAnaesthesia , Obstetricalen
dc.subjectBrain, Pathologyen
dc.subjectCaesarean Section/methodsen
dc.subjectFemaleen
dc.subject.meshAdult-
dc.subject.meshAnesthesia, Epidural-
dc.subject.meshAnesthesia, Obstetrical-
dc.subject.meshBrain-
dc.subject.meshCesarean Section-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfant, Newborn-
dc.subject.meshMagnetic Resonance Imaging-
dc.subject.meshNervous System Diseases-
dc.subject.meshPregnancy-
dc.subject.meshSturge-Weber Syndrome-
dc.subject.meshTreatment Failure-
dc.titleAnaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.en
dc.typeArticle In Pressen
dc.contributor.departmentDepartment of Anaesthesia, The Rotunda Hospital, Dublin, Ireland.en
dc.identifier.journalInternational journal of obstetric anesthesiaen
dc.description.provinceLeinster-

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