一名妊娠8周时因动脉瘤破裂导致蛛网膜下腔出血的患者：颅内动脉瘤弹簧圈栓塞作为分娩前治疗选择的有效性
A Patient with Subarachnoid Hemorrhage Related to a Ruptured Aneurysm in Week 8 of Pregnancy: Usefulness of Coil Embolization of Intracranial Aneurysms as a Treatment Option before Delivery.
作者信息
Ueda Takeshi, Kiura Yoshihiro, Isobe Naoyuki, Nishimoto Takeshi
机构信息
Department of Neurosurgery, Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Hiroshima, Japan.
Department of Neurosurgery and Endovascular Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima, Hiroshima, Japan.
出版信息
J Neuroendovasc Ther. 2020;14(1):30-35. doi: 10.5797/jnet.cr.2019-0056. Epub 2019 Dec 11.
OBJECT
We report a case of endovascular surgery for subarachnoid hemorrhage (SAH) that developed in early pregnancy.
CASE PRESENTATIONS
An 8-week pregnant 35-year-old female was admitted to our hospital with severe headache and loss of consciousness. Cephalic computed tomography (CT) revealed SAH (Hunt and Hess grade II). Digital subtraction angiography (DSA) demonstrated a 2.7 mm aneurysm at the right internal carotid artery-posterior communicating artery (IC-PC) bifurcation. We prioritized maternal treatment. Cerebral aneurysm coil embolization was performed on the 1st day under general anesthesia. During the operation, we tried to avoid irradiating the fetus by limiting the irradiation range and time. She was discharged on the 36th day of illness and gave birth to a 2532-g baby at 36 weeks of gestation.
CONCLUSION
If SAH develops in early pregnancy, it is necessary to prioritize maternal treatment. Endovascular surgery should be considered as a treatment option.
目的
我们报告一例在妊娠早期发生蛛网膜下腔出血（SAH）的血管内手术病例。
病例介绍
一名怀孕8周的35岁女性因严重头痛和意识丧失入住我院。头颅计算机断层扫描（CT）显示为SAH（Hunt和Hess分级II级）。数字减影血管造影（DSA）显示右侧颈内动脉-后交通动脉（IC-PC）分叉处有一个2.7毫米的动脉瘤。我们将母体治疗放在首位。在全身麻醉下于第1天进行了脑动脉瘤线圈栓塞术。手术过程中，我们通过限制照射范围和时间来尽量避免对胎儿的照射。她在发病第36天出院，并在妊娠36周时产下一名体重2532克的婴儿。
结论
如果在妊娠早期发生SAH，有必要将母体治疗放在首位。血管内手术应被视为一种治疗选择。
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