妊娠期特发性颅内高压的多学科管理：病例系列及叙述性综述
Multidisciplinary management of idiopathic intracranial hypertension in pregnancy: case series and narrative review.
作者信息
Alves Sara, Sousa Natacha, Cardoso Lu Ísa, Alves Joana
机构信息
Hospital de Braga, Anesthesiology Department, Braga, Portugal.
Hospital de Braga, Gynecology and Obstetrics Department, Braga, Portugal.
出版信息
Braz J Anesthesiol. 2022 Nov-Dec;72(6):790-794. doi: 10.1016/j.bjane.2021.02.030. Epub 2021 Mar 20.
Abstract
Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by raised intracranial pressure of unknown etiology with normal cerebrospinal fluid (CSF) composition and no brain lesions. It occurs in pregnant patients at approximately the same frequency as in general population, but obstetric and anesthetic management of the pregnancy and labor remains controversial. In this article we provide a multidisciplinary review of the main aspects of IIH in pregnancy including treatment options, mode of delivery and anesthetic techniques. Additionally, we report three cases of pregnant women diagnosed with IIH between 2012 and 2019 in our institution.
摘要
特发性颅内高压（IIH）是一种神经系统疾病，其特征为颅内压升高，病因不明，脑脊液（CSF）成分正常且无脑部病变。它在孕妇中的发生率与普通人群大致相同，但妊娠和分娩的产科及麻醉管理仍存在争议。在本文中，我们对妊娠IIH的主要方面进行了多学科综述，包括治疗选择、分娩方式和麻醉技术。此外，我们报告了2012年至2019年间在我们机构诊断为IIH的三名孕妇病例。
相似文献
1
Multidisciplinary management of idiopathic intracranial hypertension in pregnancy: case series and narrative review.妊娠期特发性颅内高压的多学科管理：病例系列及叙述性综述
Braz J Anesthesiol. 2022 Nov-Dec;72(6):790-794. doi: 10.1016/j.bjane.2021.02.030. Epub 2021 Mar 20.
2
Management of idiopathic intracranial hypertension in parturients: anesthetic considerations.产妇特发性颅内高压的管理：麻醉考虑因素。
Can J Anaesth. 2011 Jul;58(7):650. doi: 10.1007/s12630-011-9508-4. Epub 2011 Apr 26.
3
A combined spinal-epidural technique for labor analgesia and symptomatic relief in two parturients with idiopathic intracranial hypertension.两例特发性颅内高压产妇采用腰硬联合麻醉技术进行分娩镇痛和症状缓解。
Int J Obstet Anesth. 2012 Apr;21(2):192-4. doi: 10.1016/j.ijoa.2011.12.003. Epub 2012 Feb 10.
4
Idiopathic intracranial hypertension and pregnancy: A comprehensive review of management.特发性颅内高压与妊娠：管理的综合综述。
Clin Neurol Neurosurg. 2022 Jun;217:107240. doi: 10.1016/j.clineuro.2022.107240. Epub 2022 Apr 13.
5
Idiopathic Intracranial Hypertension - Challenges and Pearls.特发性颅内高压 - 挑战与亮点。
Neurol India. 2021 Nov-Dec;69(Supplement):S434-S442. doi: 10.4103/0028-3886.332276.
6
Choice of therapy and mode of delivery in idiopathic intracranial hypertension during pregnancy.妊娠期特发性颅内高压的治疗选择及分娩方式
MedGenMed. 2005 Nov 10;7(4):42.
7
Case Report of Idiopathic Intracranial Hypertension in Pregnancy.妊娠特发性颅内高压病例报告。
J Obstet Gynecol Neonatal Nurs. 2022 Nov;51(6):612-619. doi: 10.1016/j.jogn.2022.07.009. Epub 2022 Aug 19.
8
Spontaneous rhinorrhea and idiopathic intracranial hypertension: a complex and challenging association.自发性鼻漏和特发性颅内高压：一种复杂且具有挑战性的关联。
Neurol Neurochir Pol. 2024;58(1):31-37. doi: 10.5603/pjnns.98054. Epub 2024 Feb 23.
9
Idiopathic Intracranial Hypertension: Implications for the Otolaryngologist.特发性颅内高压：对耳鼻喉科医生的启示
Otolaryngol Clin North Am. 2022 Jun;55(3):579-594. doi: 10.1016/j.otc.2022.02.005. Epub 2022 Apr 27.
10
Rebound Intracranial Hypertension.颅内压反跳性增高。
Curr Pain Headache Rep. 2024 May;28(5):395-401. doi: 10.1007/s11916-024-01231-9. Epub 2024 Mar 2.
引用本文的文献
1
Intrapartum management of anticoagulation in a pregnant woman with acute cerebral venous sinus thrombosis undergoing vaginal delivery.一名患有急性脑静脉窦血栓形成的孕妇经阴道分娩时的产时抗凝管理。
Obstet Med. 2025 Jul 31:1753495X251361665. doi: 10.1177/1753495X251361665.
2
Idiopathic Intracranial Hypertension in Pregnancy. A Systematic Review on Clinical Course, Treatments, Delivery and Maternal-Fetal Outcome.妊娠期特发性颅内高压。关于临床病程、治疗、分娩及母婴结局的系统评价
Eur J Neurol. 2025 May;32(5):e70186. doi: 10.1111/ene.70186.
3
An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension-a comprehensive assessment of clinical outcome.特发性颅内高压症的跨学科综合专科一站式门诊——临床结局的综合评估。
Eur J Neurol. 2024 Oct;31(10):e16401. doi: 10.1111/ene.16401. Epub 2024 Aug 16.
4
An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension - a comprehensive assessment of patient satisfaction.特发性颅内高压症的跨学科综合专科一站式门诊 - 患者满意度的综合评估。
J Headache Pain. 2024 Aug 1;25(1):127. doi: 10.1186/s10194-024-01835-x.
5
An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension - an assessment of sick leave, presenteeism, and health care utilization.特发性颅内高压症的跨学科综合专科一站式门诊 - 对病假、工作效率低下和医疗保健利用的评估。
J Headache Pain. 2024 May 7;25(1):73. doi: 10.1186/s10194-024-01780-9.
6
Management and Outcome of Pregnancy in Patients With Idiopathic Intracranial Hypertension: A Prospective Case Series Study.特发性颅内高压患者的妊娠管理与结局：一项前瞻性病例系列研究
Neurol Clin Pract. 2024 Feb;14(1):e200226. doi: 10.1212/CPJ.0000000000200226. Epub 2024 Jan 5.
7
Perioperative Diagnosis and Anaesthetic Management of Idiopathic Intracranial Hypertension in Pregnancy: A Case Report.妊娠特发性颅内高压的围手术期诊断和麻醉管理：病例报告。
JNMA J Nepal Med Assoc. 2023 Mar 1;61(259):263-266. doi: 10.31729/jnma.8081.
8
Spontaneous skull base cerebrospinal fluid leak during pregnancy: a case report and review of the literature.妊娠期自发性颅底脑脊液漏：病例报告及文献复习。
BMC Pregnancy Childbirth. 2023 Mar 8;23(1):154. doi: 10.1186/s12884-023-05460-5.
9
Pregnancy and Childbirth in Women With Idiopathic Intracranial Hypertension.特发性颅内高压女性的妊娠与分娩
Cureus. 2022 Oct 18;14(10):e30420. doi: 10.7759/cureus.30420. eCollection 2022 Oct.
10
Managing idiopathic intracranial hypertension in pregnancy: practical advice.妊娠合并特发性颅内高压的管理：实用建议。
Pract Neurol. 2022 Aug;22(4):295-300. doi: 10.1136/practneurol-2021-003152. Epub 2022 Apr 21.
本文引用的文献
1
Possible association between acetazolamide administration during pregnancy and multiple congenital malformations.孕期使用乙酰唑胺与多种先天性畸形之间可能存在的关联。
Drug Des Devel Ther. 2016 Apr 15;10:1471-6. doi: 10.2147/DDDT.S99561. eCollection 2016.
2
Use of an Intrathecal Catheter for Analgesia, Anesthesia, and Therapy in an Obstetric Patient with Pseudotumor Cerebri Syndrome.在一名患有假性脑瘤综合征的产科患者中使用鞘内导管进行镇痛、麻醉和治疗。
A A Case Rep. 2016 Mar 15;6(6):160-2. doi: 10.1213/XAA.0000000000000279.
3
Anesthetic management of labor and delivery in patients with elevated intracranial pressure.颅内压升高患者分娩期的麻醉管理
Int J Obstet Anesth. 2015 May;24(2):147-60. doi: 10.1016/j.ijoa.2015.01.004. Epub 2015 Jan 19.
4
An intrathecal catheter in a pregnant patient with idiopathic intracranial hypertension: analgesia, monitor and therapy?一名患有特发性颅内高压的孕妇体内的鞘内导管：镇痛、监测与治疗？
Int J Obstet Anesth. 2014 May;23(2):175-8. doi: 10.1016/j.ijoa.2013.10.007. Epub 2013 Nov 1.
5
Neuraxial anesthesia in patients with intracranial hypertension or cerebrospinal fluid shunting systems: what should the anesthetist know?
Minerva Anestesiol. 2014 Sep;80(9):1030-45. Epub 2013 Nov 26.
6
Anaesthetic management of a case of idiopathic intracranial hypertension.一例特发性颅内高压患者的麻醉管理
Indian J Anaesth. 2013 Jul;57(4):401-3. doi: 10.4103/0019-5049.118570.
7
Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children.成人和儿童颅内假瘤综合征的修订诊断标准。
Neurology. 2013 Sep 24;81(13):1159-65. doi: 10.1212/WNL.0b013e3182a55f17. Epub 2013 Aug 21.
8
Neuraxial anesthesia in parturients with intracranial pathology: a comprehensive review and reassessment of risk.颅内病变产妇的脊麻：风险的全面回顾与再评估。
Anesthesiology. 2013 Sep;119(3):703-18. doi: 10.1097/ALN.0b013e31829374c2.
9
Idiopathic intracranial hypertension and pregnancy.特发性颅内高压与妊娠
Clin Obstet Gynecol. 2013 Jun;56(2):389-96. doi: 10.1097/GRF.0b013e31828f2701.
10
[Idiopathic intracranial hypertension: a caesarean with epidural anaesthesia after bringing the cerebrospinal fluid pressure back to normal].[特发性颅内高压：脑脊液压力恢复正常后行硬膜外麻醉剖宫产术]
Rev Esp Anestesiol Reanim. 2013 Dec;60(10):594-6. doi: 10.1016/j.redar.2012.10.008. Epub 2012 Dec 8.
Zotero 插件