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

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    Authors
    Tadrous, R
    Ni Mhuirchteagh, R
    McCaul, C
    Affiliation
    Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland.
    Issue Date
    2011-07
    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
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    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
    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
    ISSN
    1532-3374
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijoa.2010.11.011
    Scopus Count
    Collections
    Rotunda Hospital

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