Moyamoya Disease Presenting as Intracerebral Hemorrhage during Pregnancy: Case Report and Review of the Literature

Neurosurgery ◽  
1987 ◽  
Vol 20 (1) ◽  
pp. 33-35 ◽  
Author(s):  
Hitomi Enomoto ◽  
Hiroshi Goto

Abstract Intracranial hemorrhage during pregnancy is rare. The authors present a case of moyamoya disease associated with pregnancy. A 32-year-old woman who was at 32 weeks of gestation experienced sudden severe headache followed by loss of consciousness. Computed tomography revealed an intracerebral hematoma in the left temporal lobe, and left carotid angiograms revealed moyamoya disease. The patient underwent emergency craniotomy, the hematoma was removed, and encephaloduroarteriosynangiosis was performed. The patient showed good recovery and, 2 months later, delivered a child vaginally without any trouble. Most intracranial hemorrhages during pregnancy result from cerebral aneurysms or arteriovenous malformations (AVMs), and few cases due to moyamoya disease have been reported. It is generally believed that subarachnoid hemorrhage due to cerebral aneurysms is likely to occur during the middle trimester of gestation, with the risk increasing progressively toward the third trimester. This may be explained by the fact that the cardiac output increases rather acutely from the first to the middle trimester. There seems to be no significant correlation between the stage of pregnancy and the occurrence of hemorrhage due to AVM. Most authors think that the operative indications for intracranial hemorrhage during pregnancy should be the same as for the nonpregnant state.

1982 ◽  
Vol 56 (1) ◽  
pp. 131-134 ◽  
Author(s):  
Hiroshi Yuasa ◽  
Sumitaka Tokito ◽  
Kazuo Izumi ◽  
Kazuaki Hirabayashi

✓ A 51-year-old woman became unconscious 19 hours after the onset of a headache. Computerized tomography disclosed an intracerebral hematoma in the left temporal lobe, with ventricular penetration. Angiography demonstrated the characteristic appearance of cerebrovascular moyamoya disease as well as an aneurysm-like shadow in the left temporal lobe, which proved on histological examination to be a pseudoaneurysm.


2021 ◽  
Vol 12 ◽  
pp. 221
Author(s):  
Ahmed Kashkoush ◽  
Vikram Chakravarthy ◽  
Mark Bain ◽  
Iain Kalfas ◽  
Michael Steinmetz

Background: Lumbar spine surgery with or without intraoperative dural tear (DT) may contribute to postoperative subdural hematomas and/or cerebellar intracranial hemorrhages (ICHs). Here, we present two patients, one with and one without an intraoperative DT occurring during lumbar surgery, both of whom developed acute postoperative supratentorial ICHs. Case Description: Two patients developed supratentorial lobar ICH following lumbar decompressions and fusion. The first patient, without an intraoperative DT, developed multiple ICHs involving the left cerebellum and left temporal lobe. The second patient, following an L4-5 decompression/instrumented fusion involving a DT, postoperatively developed a large right frontal ICH. Conclusion: Here, two patients undergoing lumbar spine surgery with/without DT subsequently developed significant ICH.


2019 ◽  
Vol 22 (6) ◽  
pp. 116-122
Author(s):  
Sh. Sh. Shamansurov ◽  
Sh. H. Saidazizova ◽  
S. O. Nazarova

Objective. Conduct a comparative analysis of clinical and neurosonographic indicators of intracranial hemorrhage in infants.Materials and methods. In the clinical part of the study, 68 patients took part in the acute / acute periods of intracranial hemorrhage, which we took for the study on the basis of the Tashkent City Children's Clinical Hospital No1. Gender ratios of which were 69.1% boys (47 children) and 30.9% girls (21 children), from birth to 2 months of life (average age at the time of hemorrhage is 36.28 ± 9.85 days). Diagnostic examination included neurosonography (NSG) of all children in the first 24 hours of the implementation of intracranial hemorrhages on admission to the clinic.Results. According to our study of 68 children with intracranial hemorrhage, it turned out that the average age of morbidity was 36.28 ± 9.85 days (p < 0.001) Neurosonographic indicators stated the presence of parenchymal hemorrhage (right and left hemisphere), SAH (subarachnoid hemorrhage), hemorrhage into the trunk, IVH (intraventricular hemorrhage) II, IVH III. According to neurosonography, parenchymal hemorrhage (right-16 or left hemisphere-21) was observed in 37 patients, SAH and IVH-II 21 (30.9%) patients, IVH III – in 17 (25%) patients, hemorrhage in 3 (4.4%) brain stem of patientsConclusion. Analysis of the implementation of hemorrhage showed that not always small gestational age is the risk of hemorrhage. Cases of less severe changes (27%) on NSG with a coarser clinical picture and vice versa (15%), necessitate (taking into account the severity of the neurological state), a more detailed examination, including visualization (CT, MRI).


Author(s):  
M.Y. Morozova, V.V. Zotov, M.S. Kovalenko et all

Despite the rapid technological advance, the expansion of prenatal ultrasound diagnosis, as well as the accumulation of experience by both domestic and foreign experts, prenatal recognition of true knots of the umbilical cord causes significant difficulties. Three cases of successful ultrasound diagnosis of true knots of the umbilical cord and brief review of the literature are presented.


2010 ◽  
Vol 283 (S1) ◽  
pp. 19-22 ◽  
Author(s):  
Jun Kakogawa ◽  
Miyuki Sadatsuki ◽  
Norio Masuya ◽  
Hideto Gomibuchi ◽  
Hiroyasu Ohno ◽  
...  

2015 ◽  
Vol 21 (6) ◽  
pp. 654-658 ◽  
Author(s):  
Peng Liu ◽  
Xianli Lv ◽  
Youxiang Li ◽  
Ming Lv

We present three cases of cerebral aneurysms (1 unruptured; 2 ruptured) treated with endovascular techniques in pregnancies. The first ruptured case is a 28-year-old female on 20th gestational week. After the endovascular coiling, the patient suffered persistent hemiparesis and delivered a healthy baby by cesarean section. The second ruptured case is a 25-year-old female on 36th week of pregnancy. She died of aneurysm re-rupture after delivery of a healthy baby by cesarean section. The third unruptured case is a 31-year-old woman on the 26th gestational week of pregnancy who died of a giant basilar tip aneurysm after stent-assisted coiling. Ruptured aneurysm obliteration should be prioritized followed by vaginal delivery or cesarean section. The decision regarding the treatment of unruptured aneurysms should be carefully considered on a case-by-case basis. Stent-assisted coiling may be applicable to aneurysm during pregnancy.


2021 ◽  
Vol 20 ◽  
Author(s):  
Mustafa Etli ◽  
Oguz Karahan

Abstract Moyamoya disease is a rare disorder that involves the cerebrovascular system. Usually, it leads to occlusion of the arteries of the cerebral system and causes cerebral circulatory complaints. A 48-year-old female patient was admitted to our clinic with intermittent claudication in both legs. Biphasic and monophasic waveform patterns were detected bilaterally in distal (trifurcation arteries) lower extremities with Doppler sonography. The patient therefore underwent systemic vascular examination. Computed tomography angiography revealed bilateral carotid occlusion at the level of supraclinoid segments, and opacifications were detected at the distal segments of the bilateral anterior cerebellar and middle cerebellar arteries. The patient was diagnosed with moyamoya disease, and anticoagulant treatment was started. In conclusion, most previous reports have presented the cerebrovascular involvement of moyamoya disease. However, this disease can involve different peripheral vascular systems and careful and systemic vascular examination is necessary for an exact diagnosis.


2021 ◽  
pp. 1-2
Author(s):  
Kirill Alekseyev ◽  

Coronavirus disease 2019 (COVID-19) is a pandemic that began in December 2019 as a result of the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We frequently associate COVID-19 with symptoms of fever, shortness of breath, and pneumonia; however, we are slowly uncovering the fact that systems other than the respiratory are being affected. We present a 60-year-old female who presented with altered mental status and was found to have COVID-19 induced subdural hematoma. Although intracranial hemorrhages are extremely rare in the setting of COVID-19, it is known that the affinity of SARS-CoV-2 to the angiotensin-converting enzyme 2 receptors, in addition to the cytokine storm, predisposes infected individuals to intracranial hemorrhages. Thus, it is crucial to consider intracranial hemorrhage as a possible cause of altered mental status in patients infected with COVID-19 and weigh the potential risk versus benefits of utilizing anticoagulants when managing the thrombotic complications of this virus.


2015 ◽  
Vol 21 (3) ◽  
pp. 332-336 ◽  
Author(s):  
Jean-Christophe Gentric ◽  
Joelle Brisson ◽  
André Lima Batista ◽  
Jimmy Ghostine ◽  
Jean Raymond ◽  
...  

Background and purpose We aimed to determine the safety of intra-arterial Abciximab injection in the management of thromboembolic complications during endovascular treatment of ruptured cerebral aneurysms. Methods In a monocentric consecutive series of endovascular treatment of 783 ruptured aneurysms, 42 (5.3%) patients received Abciximab after the aneurysm was secured. Bleeding complications were registered and dichotomized as follows: new intracranial hemorrhage and peripheral bleeding. For each patient, World Federation of Neurosurgery (WFNS) subarachnoid hemorrhage (SAH) grade, shunting, and clinical outcomes in the post-operative period and at 3–6 months were recorded. Results SAH WFNS grades were as follows: grade I n = 14, grade II n = 10, grade III n = 11, grade IV n = 4, grade V n = 3. Ten patients had intracranial hematoma additionally to the SAH prior to embolization. Four patients (9.5%) presented more blood on the post-embolization CT but only one suffered a new clinically relevant intracranial hemorrhage. Two patients (4.8%) experienced significant peripheral bleeding but none were associated with long-term disabilities. Fourteen patients had a shunt installed less than 24 h prior to Abciximab injection and one less than 48 h later. At 3–6-month follow-up, 31 patients (74%) achieved a modified Rankin Scale score (mRS) of 2 or less, six patients (14%) had a mRS of 3–5, three were dead (7%), and two were lost at follow-up. Conclusion When the aneurysm is secured, intra-arterial Abciximab injection is a low complication rate treatment modality for thromboembolic events during embolization of cerebral ruptured aneurysm.


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