Song Jae Gyok, Kim Seok Kon, Eun Jong Hyun
Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea.
Korean J Anesthesiol. 2009 May;56(5):592-596. doi: 10.4097/kjae.2009.56.5.592.
Intracerebral hemorrhage (ICH) is one of very dangerous complications of preeclampsia/eclampsia. We experienced postoperative ICH in a 39-year-old woman with preeclampsia and HELLP syndrome. The paturient complained severe headache and upper abdominal pain with nausea and vomiting. Her initial blood pressure was 190/120 mmHg and her heart rate was 80 beat/min. The diagnosis of preeclampsia with HELLP syndrome was confirmed by the severe hypertension and the laboratory findings. She was drowsy at the emergency room but she lost consciousness when transferring to the operation room. Caesarean section was done under general anesthesia. After the operation she could not recover self-respiration and consciousness. Her brain CT showed ICH in the basal ganglia with intraventricular hemorrhage and severe brain edema. She expired one the 5 th post operative day due to brain death and multiple organ failure. Early diagnosis is the key to treating ICH.
脑出血(ICH)是先兆子痫/子痫非常危险的并发症之一。我们遇到一名患有先兆子痫和HELLP综合征的39岁女性术后发生脑出血。该产妇主诉严重头痛、上腹部疼痛伴恶心呕吐。她的初始血压为190/120 mmHg,心率为80次/分钟。严重高血压和实验室检查结果证实了先兆子痫合并HELLP综合征的诊断。她在急诊室时昏昏欲睡,但在转至手术室时失去意识。在全身麻醉下进行了剖宫产。术后她无法恢复自主呼吸和意识。她的脑部CT显示基底节区脑出血伴脑室内出血和严重脑水肿。她在术后第5天因脑死亡和多器官衰竭而死亡。早期诊断是治疗脑出血的关键。