Department of Obstetrics and Gynecology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan; Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2024 Jul;63(4):552-556. doi: 10.1016/j.tjog.2023.09.026.
Cerebral arteriovenous malformation during pregnancy is rare but lethal disease that usually present with new-onset seizures and headaches mimicking eclampsia. We report a rare case of cerebral arteriovenous malformation with abrupt seizures in the third trimester.
A 28-year-old primipara was brought to our emergency department at 32 6/7 weeks of gestation with new-onset acute seizures and hypertension. Owing to neurological deterioration, the patient underwent emergency cesarean delivery. However, 24 h after cesarean delivery and eclampsia treatment, the seizures worsened. Computed tomography and magnetic resonance imaging showed unruptured arteriovenous malformation of the right frontal lobe. Subsequently, intraarterial embolization was performed. The patient was discharged 5 days after surgery without neurological sequelae or obstetric complications.
This case report highlights the differential diagnoses of sudden new-onset seizures in late pregnancy for obstetricians and emergency medicine physicians. Lethal cerebral diseases, apart from eclampsia, should be considered during pregnancy.
脑动静脉畸形在妊娠期间较为罕见，但却是一种致命性疾病，通常表现为新发的癫痫发作和头痛，类似于子痫。我们报告一例罕见的妊娠晚期突发癫痫的脑动静脉畸形病例。
一名 28 岁初产妇，在妊娠 32 周+6/7 时因新发急性癫痫发作和高血压被送往我院急诊。由于神经功能恶化，患者接受了紧急剖宫产。然而，在剖宫产和子痫治疗后 24 小时，癫痫发作恶化。计算机断层扫描和磁共振成像显示右侧额叶未破裂的动静脉畸形。随后进行了动脉内栓塞治疗。患者术后 5 天出院，无神经后遗症或产科并发症。
本病例报告强调了妇产科医生和急诊医生在妊娠晚期突然新发癫痫发作时需要进行鉴别诊断。除了子痫外，在妊娠期间还应考虑其他致命性脑部疾病。
