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脑海绵状血管瘤患者产科与麻醉技术选择的困境:一例报告

The dilemma of choosing obstetrics and anesthesia techniques in a patient with cerebral cavernomatosis: a case report.

作者信息

López Pérez Verónica, Jaro Mercedes, Arcas Jose J, Del Olmo Mercedes, Tebar Maria Y

机构信息

Hospital Universitario 12 de Octubre, Madrid, Spain.

Hospital Universitario 12 de Octubre, Madrid, Spain.

出版信息

Braz J Anesthesiol. 2022 Jul-Aug;72(4):516-518. doi: 10.1016/j.bjane.2021.03.027. Epub 2021 May 11.

Abstract

This report describes the case of a pregnant woman who arrived for preanesthetic assessment of External Cephalic Version (ECV) for fetus in breech presentation and cesarean section in case of ECV failure. Although the technique seems simple, attempts to rotate the fetus can result in elevated intracranial pressure, which might cause malformation bleeding. The most appropriate anesthetic technique in cases of arteriovenous malformations during C-sections has not been determined. Neuroaxial anesthesia is safe only in stable brain cavernomas, but the presence of spinal malformations contraindicates it. Anesthetic goals include stabilizing the blood pressure and reducing the risk of rupture.

摘要

本报告描述了一名孕妇的病例,该孕妇前来接受针对臀位胎儿的外倒转术(ECV)的麻醉前评估,若ECV失败则进行剖宫产。尽管该技术看似简单,但尝试转动胎儿可能会导致颅内压升高,进而可能引起畸形出血。剖宫产期间动静脉畸形病例中最合适的麻醉技术尚未确定。神经轴麻醉仅在稳定的脑海绵状血管瘤中是安全的,但存在脊柱畸形则为其禁忌证。麻醉目标包括稳定血压并降低破裂风险。

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