Obstetrics and Gynaecology, Medisch Spectrum Twente, Enschede, The Netherlands.
Neurosurgery, Medisch Spectrum Twente, Enschede, The Netherlands.
BMJ Case Rep. 2024 Mar 19;17(3):e258066. doi: 10.1136/bcr-2023-258066.
We report a case of a mid-20s primigravida at 37 weeks' gestation who presented with severe headache and acute neurological deterioration. The CT brain scan showed hydrocephalus caused by a colloid cyst in the third ventricle. The patient underwent emergency placement of an external ventricular drain for decompression of acute hydrocephalus. Four hours later, labour commenced spontaneously, and in view of her neurological status, a decision was taken to perform a caesarean section under general anaesthetics. Four days postpartum, the patient underwent an endoscopic removal of the cyst. Intracranial emergencies during pregnancy are rare and challenging to manage. The mortality rate can be significant. Diagnostic and surgical intervention should not be delayed because of pregnancy. An individualised treatment approach is required with multidisciplinary input. The collaborative efforts of our multidisciplinary team resulted in prompt diagnosis and surgical treatment in this case that resulted in both a healthy mother and child.
我们报告了一例 20 多岁的初产妇，妊娠 37 周，出现严重头痛和急性神经功能恶化。脑部 CT 扫描显示第三脑室的胶样囊肿引起脑积水。患者行紧急脑室外引流术以缓解急性脑积水。4 小时后，自然分娩开始，鉴于她的神经状态，决定在全身麻醉下进行剖宫产。产后 4 天，患者行内镜下囊肿切除术。怀孕期间的颅内急症罕见且难以处理。死亡率可能很高。不应因怀孕而延迟诊断和手术干预。需要采用个体化治疗方法并多学科参与。我们的多学科团队的协作努力在本例中实现了快速诊断和手术治疗，母婴均健康。
