Revuelta D, López-Baamonde M, Vendrell M, Plaza A, Cobo T, Magaldi M
Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, Spain.
Servicio de Ginecología y Obstetricia, Hospital Clínic de Barcelona, Barcelona, Spain.
Rev Esp Anestesiol Reanim (Engl Ed). 2025 Jan;72(1):101623. doi: 10.1016/j.redare.2024.101623. Epub 2024 Nov 12.
Idiopathic intracranial hypertension (IIH) is a condition characterized by elevated intracranial pressure (ICP) of unknown etiology, more prevalent in obese women of childbearing age. The management of IIH during pregnancy represents a multidisciplinary challenge, as medical treatment is contentious due to the foetal teratogenic risk, and the technically challenging placement of a ventriculoperitoneal shunt is hindered by the presence of the pregnant uterus. The goal of anaesthetic management during childbirth is to maintain hemodynamic stability, cerebral perfusion pressure, and cerebral tissue oxygenation, while avoiding abrupt fluctuations in intracranial pressure. The choice of anaesthetic technique is complex and depends on the assessment of risks and benefits associated with each technique, involving a decision between neuraxial anaesthesia and general anaesthesia. We present the case of a pregnant woman with rapidly progressing IIH, approached in a multidisciplinary manner, whose anaesthetic management was technically challenging, resulting in a favourable outcome without subsequent complications.
特发性颅内高压（IIH）是一种以颅内压（ICP）升高为特征但病因不明的病症，在育龄肥胖女性中更为常见。孕期IIH的管理是一项多学科挑战，因为由于胎儿致畸风险，药物治疗存在争议，而且怀孕子宫的存在阻碍了脑室腹腔分流术在技术上具有挑战性的放置。分娩期间麻醉管理的目标是维持血流动力学稳定、脑灌注压和脑组织氧合，同时避免颅内压的突然波动。麻醉技术的选择很复杂，取决于对每种技术相关风险和益处的评估，涉及在椎管内麻醉和全身麻醉之间做出决定。我们介绍了一名患有快速进展性IIH的孕妇的病例，该病例采用多学科方法处理，其麻醉管理在技术上具有挑战性，但取得了良好的结果且无后续并发症。
