PDF herunterladen
CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2014; 01(03): 166-172
DOI: 10.4103/2348-0548.139095
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Neurosurgery and pregnancy

Rajkumar Subramanian
1   Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
,
Arijit Sardar
1   Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
,
S. Mohanaselvi
1   Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
,
Puneet Khanna
1   Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
,
Dalim K. Baidya
1   Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
› Institutsangaben
Verantwortlicher Herausgeber dieser Rubrik:
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
30. April 2018 (online)

Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Pregnant patients rarely present with neurosurgical emergencies, but can cause significant morbidity and mortality to the mother and the foetus. Physiological changes of pregnancy in relevance to neurosurgery, effects of anaesthetic agents on the foetus, common neurosurgical emergencies, and anaesthetic implications both from obstetric and neurosurgical point of view are discussed in this review.

Keywords

Aneurysm - subarachnoid haemorrhage - teratogenicity
 

  • REFERENCES

  • 1 Vlak MH, Algra A, Brandenburg R, Rinkel GJ. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: A systematic review and meta-analysis. Lancet Neurol 2011; 10: 626-36
    CrossrefPubMedGoogle Scholar
  • 2 Bateman BT, Olbrecht VA, Berman MF, Minehart RD, Schwamm LH, Leffert LR. Peripartum subarachnoid hemorrhage: Nationwide data and institutional experience. Anaesthesiology 2012; 116: 324-33
    CrossrefPubMedGoogle Scholar
  • 3 Guy J, McGrath BJ, Borel CO, Friedman AH, Warner DS. Perioperative management of aneurysmal subarachnoid haemorrhage: Part 1. Operative management. Anesth Analg 1995; 81: 1060-72
    PubMedGoogle Scholar
  • 4 Dias MS, Sekhar LN. Intracranial haemorrhage from aneurysms and arteriovenous malformations during pregnancy and the puerperium. Neurosurgery 1990; 27: 855-65
    CrossrefPubMedGoogle Scholar
  • 5 Carvalho Lde S, Vilas Boas WW. Anesthetic conduct in cesarean section in a parturient with unruptured intracranial aneurysm. Rev Bras Anestesiol 2009; 59: 746-50
    PubMedGoogle Scholar
  • 6 Ng O, Thong SY. Spinal anaesthesia for emergency caesarean section in a parturient with acute subarachnoid haemorrhage. OA Case Reports 2013; 2: 25
    PubMedGoogle Scholar
  • 7 Vale BP, Albuquerque MG, Brito JN, Portela AL, Paiva JT. Giant intracranial aneurysm rupture in pregnant woman treated by endovascular embolization: A case report. Radiol Bras 2006; 39: 237-9
    CrossrefPubMedGoogle Scholar
  • 8 Meyers PM, Halbach VV, Malek AM, Phatouros CC, Dowd CF, Lawton MT. et al. Endovascular treatment of cerebral artery aneurysms during pregnancy: Report of three cases. AJNR Am J Neuroradiol 2000; 21: 1306-11
    PubMedGoogle Scholar
  • 9 Gill TE, Mani S, Dessables DR. Anesthetic management of cerebral aneurysm clipping during pregnancy: A case report. AANA J 1993; 61: 282-6
    PubMedGoogle Scholar
  • 10 Simolke GA, Cox SM, Cunningham FG. Cerebrovascular accidents complicating pregnancy and the puerperium. Obstet Gynecol 1991; 78: 37-42
    PubMedGoogle Scholar
  • 11 Kocak A, Ates O, Cayli SR, Sarac K. Pregnant woman with subarachnoid haemorrhage and multiple intracranial aneurysms: A case report. Turk Neurosurg 2006; 16: 100-4
    PubMedGoogle Scholar
  • 12 Indu S, Batra YK, Indu B, Chhari P. Anaesthesia for caesarean section in a parturient with complicated intracerebral aneurysm following unsuccessful endovascular coiling. Indian J Anaesth 2005; 49: 56-8
    PubMedGoogle Scholar
  • 13 Barrett JM, Van Hooydonk JE, Boehm FH. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv 1982; 37: 557-66
    CrossrefPubMedGoogle Scholar
  • 14 Coolen T. Post eclamptic aneurysmal rupture subarachnoid haemorrhage diagnosed in the puerperium. Radiographer 2006; 53: 22-6
    CrossrefPubMedGoogle Scholar
  • 15 Priebe HJ. Aneurysmal subarachnoid haemorrhage and the anaesthetist. Br J Anaesth 2007; 99: 102-18
    CrossrefPubMedGoogle Scholar
  • 16 Kim YW, Neal D, Hoh BL. Cerebral aneurysms in pregnancy and delivery: Pregnancy and delivery do not increase the risk of aneurysm rupture. Neurosurgery 2013; 72: 143-9
    CrossrefPubMedGoogle Scholar
  • 17 Tiel Groenestege AT, Rinkel GJ, van der Bom JG, Algra A, Klijn CJ. The risk of aneurysmal subarachnoid haemorrhage during pregnancy, delivery, and the puerperium in the Utrecht population: Case-crossover study and standardized incidence ratio estimation. Stroke 2009; 40: 1148-51
    CrossrefPubMedGoogle Scholar
  • 18 Wilson SR, Hirsch NP, Appleby I. Management of subarachnoid haemorrhage in a non-neurosurgical centre. Anaesthesia 2005; 60: 470-85
    CrossrefPubMedGoogle Scholar
  • 19 Eggert SM, Eggers KA. Subarachnoid haemorrhage following spinal anaesthesia in an obstetric patient. Br J Anaesth 2001; 86: 442-4
    CrossrefPubMedGoogle Scholar
  • 20 Minielly R, Yuzpe AA, Drake CG. Subarachnoid haemorrhage secondary to ruptured cerebral aneurysm in pregnancy. Obstet Gynecol 1979; 53: 64-70
    PubMedGoogle Scholar
  • 21 Dinç H, Öztürk MH, Sari A, Çakir E, Gazioglu G, Kuzeyli K. Coil embolization in 481 ruptured intracranial aneurysms: Angiographic and clinical results. Diagn Interv Radiol 2013; 19: 165-72
    PubMedGoogle Scholar
  • 22 Laidler JA, Jackson IJ, Redfern N. The management of caesarean section in a patient with an intracranial arteriovenous malformation. Anaesthesia 1989; 44: 490-1
    CrossrefPubMedGoogle Scholar
  • 23 Carvalho CS, Resende F, Centeno MJ, Ribeiro I, Moreira J. Anesthetic approach of pregnant woman with cerebral arteriovenous malformation and subarachnoid haemorrhage during pregnancy: Case report. Rev Bras Anestesiol 2013; 63: 223-6
    PubMedGoogle Scholar
  • 24 Pasqualin A, Barone G, Cioffi F, Rosta L, Scienza R, Da Pian R. The relevance of anatomic and haemodynamic factors to a classification of cerebral arteriovenous malformations. Neurosurgery 1991; 28: 370-9
    CrossrefPubMedGoogle Scholar
  • 25 Nagamine N, Shintani N, Furuya A, Suzuki S, Nonaka A, Abe F. et al. Anesthetic managements for emergency cesarean section and craniotomy in patients with intracranial haemorrhage due to ruptured cerebral aneurysm and arteriovenous malformation. Masui 2007; 56: 1081-4
    PubMedGoogle Scholar
  • 26 Haas JF, Jänisch W, Staneczek W. Newly diagnosed primary intracranial neoplasms in pregnant women: A population-based assessment. J Neurol Neurosurg Psychiatry 1986; 49: 874-80
    CrossrefPubMedGoogle Scholar
  • 27 Bickerstaff ER, Small JM, Guest IA. The relapsing course of certain meningiomas in relation to pregnancy and menstruation. J Neurol Neurosurg Psychiatry 1958; 21: 89-91
    CrossrefPubMedGoogle Scholar
  • 28 Stevenson CB, Thompson RC. The clinical management of intracranial neoplasms in pregnancy. Clin Obstet Gynecol 2005; 48: 24-37
    CrossrefPubMedGoogle Scholar
  • 29 Lin SH, Kleinberg LR. Carmustine wafers: Localized delivery of chemotherapeutic agents in CNS malignancies. Expert Rev Anticancer Ther 2008; 8: 343-59
    CrossrefPubMedGoogle Scholar
  • 30 Lockshin MD, Sammaritano LR. Corticosteroids during pregnancy. Scand J Rheumatol Suppl 1998; 107: 136-8
    PubMedGoogle Scholar
  • 31 Klein AM. Epilepsy cases in pregnant and postpartum women: A practical approach. Semin Neurol 2011; 31: 392-6
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 32 Kal HB, Struikmans H. Radiotherapy during pregnancy: Fact and fiction. Lancet Oncol 2005; 6: 328-33
    CrossrefPubMedGoogle Scholar
  • 33 Yu C, Jozsef G, Apuzzo ML, MacPherson DM, Petrovich Z. Fetal radiation doses for model C gamma knife radiosurgery. Neurosurgery 2003; 52: 687-93
    CrossrefPubMedGoogle Scholar
  • 34 Abd-Elsayed AA, Díaz-Gómez J, Barnett GH, Kurz A, Inton-Santos M, Barsoum S. et al. A case series discussing the anaesthetic management of pregnant patients with brain tumours. F1000Res 2013; 2: 92
    CrossrefPubMedGoogle Scholar
  • 35 Giannini A, Bricchi M. Posterior fossa surgery in the sitting position in a pregnant patient with cerebellopontine angle meningioma. Br J Anaesth 1999; 82: 941-4
    CrossrefPubMedGoogle Scholar
  • 36 Chang L, Looi-Lyons L, Bartosik L, Tindal S. Anaesthesia for cesarean section in two patients with brain tumours. Can J Anaesth 1999; 46: 61-5
    CrossrefPubMedGoogle Scholar
  • 37 Muench MV, Canterino JC. Trauma in pregnancy. Obstet Gynecol Clin North Am 2007; 34: 555-83 xiii
    CrossrefPubMedGoogle Scholar
  • 38 Mirza FG, Devine PC, Gaddipati S. Trauma in pregnancy: A systematic approach. Am J Perinatol 2010; 27: 579-86
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 39 Chowdhury T, Chowdhury M, Schaller B, Cappellani RB, Daya J. Perioperative considerations for neurosurgical procedures in the gravid patient: Continuing Professional Development. Can J Anaesth 2013; 60: 1139-55
    CrossrefPubMedGoogle Scholar
  • 40 Berry C, Ley EJ, Mirocha J, Margulies DR, Tillou A, Salim A. Do pregnant women have improved outcomes after traumatic brain injury?. Am J Surg 2011; 201: 429-32
    CrossrefPubMedGoogle Scholar
  • 41 Kim HS, Kim SW, Lee SM, Shin H. Endoscopic discectomy for the cauda equina syndrome during third trimester of pregnancy. J Korean Neurosurg Soc 2007; 42: 419-20
    CrossrefPubMedGoogle Scholar
  • 42 Brown MD, Levi AD. Surgery for lumbar disc herniation during pregnancy. Spine (Phila Pa 1976) 2001; 26: 440-3
    CrossrefPubMedGoogle Scholar
  • 43 Han IH, Kuh SU, Kim JH, Chin DK, Kim KS, Yoon YS. et al. Clinical approach and surgical strategy for spinal diseases in pregnant women: A report of ten cases. Spine (Phila Pa 1976) 2008; 33: E614-9
    CrossrefPubMedGoogle Scholar
  • 44 Selo-Ojeme DO, Marshman LA, Ikomi A, Ojutiku D, Aspoas RA, Chawda SJ. et al. Aneurysmal subarachnoid haemorrhage in pregnancy. Eur J Obstet Gynecol Reprod Biol 2004; 116: 131-43
    CrossrefPubMedGoogle Scholar