Mahendram Sujeivan, Eichenbaum Kenneth
Anesthesiology, Wayne State University School of Medicine, Pontiac, USA.
Anesthesiology, Oakland University William Beaumont School of Medicine, Rochester, USA.
Cureus. 2023 Sep 20;15(9):e45613. doi: 10.7759/cureus.45613. eCollection 2023 Sep.
Acute stroke is a time-sensitive medical diagnosis, and current standardized management algorithms do not specifically streamline care for pregnant patients with these symptoms. Here, we discuss the management of a 29-year-old parturient with a history of systemic lupus erythematosus (SLE) who presented with stroke-like symptoms. We discuss strategies to improve care by incorporating formal neurological and ophthalmologic evaluations prior to referral for neuraxial intervention, particularly in light of the developing concerns among ophthalmologists that retinal transient ischemic attacks (TIAs) and visual symptoms should be treated with the same acuity as cerebral TIAs and strokes. We propose an integrated stroke algorithm in the pregnant population with consideration for specific ophthalmologic evaluation. In the present case, labor induction and epidural placement were successfully performed once a more optimized workup was completed.
急性中风是一种对时间敏感的医学诊断，而目前的标准化管理算法并未专门简化对有这些症状的孕妇的护理流程。在此，我们讨论了一名29岁有系统性红斑狼疮（SLE）病史的产妇出现类似中风症状的管理情况。我们讨论了在转诊进行神经轴索干预之前纳入正式的神经学和眼科评估以改善护理的策略，特别是鉴于眼科医生越来越担心视网膜短暂性脑缺血发作（TIAs）和视觉症状应与脑TIAs和中风一样以相同的敏锐度进行治疗。我们提出了一种针对孕妇群体的综合中风算法，并考虑进行特定的眼科评估。在本病例中，一旦完成了更优化的检查，就成功进行了引产和硬膜外置管。
