Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.
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Affiliation
Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland.Issue Date
2011-07Keywords
AdultAnaesthesia, Epidural
Anaesthesia , Obstetrical
Brain, Pathology
Caesarean Section/methods
Female
MeSH
AdultAnesthesia, Epidural
Anesthesia, Obstetrical
Brain
Cesarean Section
Female
Humans
Infant, Newborn
Magnetic Resonance Imaging
Nervous System Diseases
Pregnancy
Sturge-Weber Syndrome
Treatment Failure
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Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration. 2011, 20 (3):259-62 Int J Obstet AnesthPublisher
ElsevierJournal
International journal of obstetric anesthesiaDOI
10.1016/j.ijoa.2010.11.011PubMed ID
21315576Abstract
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 PressLanguage
enISSN
1532-3374ae974a485f413a2113503eed53cd6c53
10.1016/j.ijoa.2010.11.011
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