Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.
AffiliationDepartment of Anaesthesia, The Rotunda Hospital, Dublin, Ireland.
Magnetic Resonance Imaging
Nervous System Diseases/*etiology/therapy
MetadataShow full item record
CitationInt J Obstet Anesth. 2011 Jul;20(3):259-62. Epub 2011 Feb 18.
JournalInternational journal of obstetric anesthesia
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.
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