• World Neurosurg · Aug 2020

    Case Reports

    How would you treat a pregnant woman with a rupture of cranial aneurysm at the second trimester of pregnancy? A case report.

    • Emine Karabuk, Pinar Kadirogullari, Talat Umut Kutlu Dilek, Enes Ozluk, and Gulsah Ozturk.
    • Department of Obstetrics and Gynecology, Acıbadem University Atakent Hospital, Istanbul, Turkey.
    • World Neurosurg. 2020 Aug 1; 140: 229-232.

    BackgroundReports of cerebral aneurysm and aneurysm rupture during pregnancy are rare in the literature. Aneurysms might rupture and cause intracranial hemorrhage during or after pregnancy. Aneurysmal subarachnoid hemorrhage during pregnancy presents a challenge regarding treatment and management. No institution has reported a large patient population or experience in managing this condition during pregnancy in the literature. Owing to the limited number of cases, there are no available treatment guidelines, and treatment is usually based on a case-by-case approach.Case DescriptionA 31-year-old woman presented in the 27th week of pregnancy with sudden-onset headache, which was diagnosed as subarachnoid hemorrhage. The diagnosis of subarachnoid hemorrhage with an aneurysm located on the anterior communicating artery was made with magnetic resonance imaging and digital subtraction angiography. The aneurysm was treated by surgical clipping. The pregnancy continued successfully until the 35th gestational week, when the infant was successfully delivered by planned cesarean section owing to preeclampsia and fetal growth retardation. Postoperative follow-up was uneventful.ConclusionsWe present our experience in the management of aneurysmal subarachnoid hemorrhage during pregnancy and maternal and fetal outcomes of this rare disease. More cases and multicenter studies are needed to develop standardized management of this disease.Copyright © 2020 Elsevier Inc. All rights reserved.

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