scholarly journals A case series of craniotomy in obstetric patients: a lifesaving treatment modality

2018 ◽  
Vol 7 (5) ◽  
pp. 2055
Author(s):  
S. S. Subha ◽  
Mohana Dhanapal ◽  
Aiswary .
Keyword(s):  
Case Series ◽  
Third Trimester ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
The Third ◽  
Cortical Vein Thrombosis ◽  
Life Saving ◽  
The Common ◽  
A Prospective Study ◽  
In Pregnancy

BACKGROUND:Neurosurgical disorders are a significant cause of non-obstetric death and disability in pregnant women. They pose a unique therapeutic challenge. The changes in normal physiology during pregnancy add to the complexity of management. The common conditions encountered are intracranial hemorrhage, tumours, trauma and spinal pathologies. It is preferrable to wait until the third trimester if the indication is semi-elective.MATERIALS AND METHODS: Here we present a prospective study of four cases , managed with neurosurgery in pregnancy and puerperium.RESULTS: Of the 4 cases two cases were craniotomy done for cortical vein thrombosis and two cases of excision of space occupying lesions.  CONCLUSIONS: Pregnancy itself should not be considered a contra-indication to neurosurgery, which when considered early in some patients, proves to be life-saving.

scholarly journals Isolated cortical vein thrombosis: case series

2015 ◽  
Vol 123 (2) ◽  
pp. 427-433 ◽  
Author(s):  
Ranjodh Singh ◽  
William P. Cope ◽  
Zhiping Zhou ◽  
Michelle E. De Witt ◽  
John A. Boockvar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Hypotension ◽  
Vasogenic Edema ◽  
Anticoagulation Therapy ◽  
Case Series ◽  
Published Data ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Presenting Symptoms ◽  
Cortical Vein Thrombosis

OBJECT Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of all cerebral infarctions. ICVT may cause irreversible parenchymal damage, rendering early and accurate diagnosis critical. This case series and literature review presents the clinical and radiological findings in 7 patients with ICVT, and highlights risk factors and imaging modalities that may be most beneficial in rendering an accurate and timely diagnosis. METHODS Patients with CT and MRI findings consistent with ICVT examined between January 2011 and June 2014 were included in this retrospective review. RESULTS Seven patients (5 females, 2 males), ranging in age from 11 months to 34 years, met the inclusion criteria. The most common clinical presentations were headaches (n = 4) and seizures (n = 3). The most common comorbidities noted in these patients were hypercoagulable states (n = 4) and intracranial hypotension (n = 3). Five patients had intraparenchymal involvement. CT suggested the correct diagnosis in 4 patients, and MRI confirmed the diagnosis in all 7 patients. All patients who received anticoagulation therapy (n = 5) experienced complete resolution of their symptoms. CONCLUSIONS The majority of these patients were adult females, consistent with published data. Seizures and headaches were the most common presenting symptoms. Hypercoagulable state and intracranial hypotension, both known risk factors for thrombosis, were the most commonly noted ICVT risk factors. Intraparenchymal involvement was prevalent in nearly all ICVT cases and presented as vasogenic edema, early intraparenchymal hemorrhage, or hemorrhagic venous infarction. Susceptibility-weighted imaging was the most sensitive imaging technique in diagnosing ICVT.

scholarly journals Hypoparathyroidism and pseudohypoparathyroidism in pregnancy: an Italian retrospective observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gemma Marcucci ◽  
Paola Altieri ◽  
Salvatore Benvenga ◽  
Marta Bondanelli ◽  
Valentina Camozzi ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Serum Albumin ◽  
Post Partum ◽  
Case Series ◽  
Total Calcium ◽  
Third Trimester ◽  
The Third ◽  
The Mean ◽  
The Individual ◽  
In Pregnancy

Abstract Background Hypoparathyroidism (HypoPT) or pseudo-hypoparathyroidism (pseudo-HypoPT) during pregnancy may cause maternal and fetal/neonatal complications. In this regard, only a few case reports or case series of pregnant or lactating women have been published. The purpose of this study was to describe clinical and biochemical course, pharmacological management, and potential adverse events during pregnancy and post-partum in pregnant women with HypoPT or pseudo-HypoPT. This was a retrospective, observational, multicenter, study involving nine Italian referral centers for endocrine diseases affiliated with the Italian Society of Endocrinology and involved in “Hypoparathyroidism Working Group”. Results This study identified a cohort of 28 women (followed between 2005 and 2018) with HypoPT (n = 25, 84% postsurgical, 16% idiopathic/autoimmune) and pseudo-HypoPT (n = 3). In HypoPT women, the mean calcium carbonate dose tended to increase gradually from the first to third trimester (+ 12.6%) in pregnancy. This average increase in the third trimester was significantly greater compared to the pre-pregnancy period (p value = 0.03). However, analyzing the individual cases, in 44% the mean calcium dosage remained unchanged throughout gestation. Mean calcitriol doses tended to increase during pregnancy, with a statistically significant increase between the third trimester and the pre-pregnancy period (p value = 0.02). Nevertheless, analyzing the individual cases, in the third trimester most women with HypoPT (64%) maintained the same dosage of calcitriol compared to the first trimester. Both mean calcium carbonate and calcitriol doses tended to decrease from the third trimester to the post-partum six months. Most identified women (~ 70%) did not display maternal complications and (~ 90%) maintained mean serum albumin-corrected total calcium levels within the low-to-mid normal reference range (8.5 ± 0.8 mg/dl) during pregnancy. The main complications related to pregnancy period included: preterm birth (n = 3 HypoPT women), and history of miscarriages (n = 6 HypoPT women and n = 2 pseudo-HypoPT women). Conclusion This study shows that mean serum albumin-corrected total calcium levels were carefully monitored during pregnancy and post-pregnancy, with limited evaluation of other biochemical parameters, such as serum phosphate, 24 h urinary calcium, 25-OH vitamin D, and creatinine clearance. To avoid complications in mothers affected by (HypoPT) or (pseudo-HypoPT) and offspring, intense biochemical, clinical and pharmacological monitoring during pregnancy and breastfeeding is highly recommended.

scholarly journals Pregnancy and ketoacidosis: Is pancreatitis a missing link?

2015 ◽  
Vol 9 (2) ◽  
pp. 60-63 ◽  
Author(s):  
Charlotte J Frise ◽  
Anna Ashcroft ◽  
Bryony A Jones ◽  
Lucy Mackillop
Keyword(s):  
Diabetic Ketoacidosis ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Metabolic Abnormalities ◽  
Third Trimester ◽  
Missing Link ◽  
The Third ◽  
In Pregnancy

Non-diabetic ketoacidosis is increasingly recognised in pregnancy, particularly during the third trimester, and is usually associated with vomiting. In many cases, the cause of the vomiting is not identified and resolves rapidly, alongside the metabolic abnormalities, following delivery. Here, we report three cases in which pancreatitis was identified as an underlying cause of the gastrointestinal symptoms. To our knowledge, these are the first reports of pancreatitis precipitating non-diabetic ketoacidosis in pregnancy. This case series highlights the importance of searching for a precipitant for non-diabetic ketoacidosis in pregnancy, rather than focusing solely on management of the resulting metabolic abnormalities.

Multimodal diagnosis of cortical vein thrombosis

2007 ◽  
Vol 34 (S 2) ◽  
Author(s):  
J Linn ◽  
T Pfefferkorn ◽  
S Michl ◽  
M Wiesmann ◽  
S Hartz ◽  
...  
Keyword(s):  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis

scholarly journals Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongfeng Wen ◽  
Di Jin ◽  
Yu Chen ◽  
Bin Cui ◽  
Tianyi Xiao
Keyword(s):  
Venous Thrombosis ◽  
Polycythemia Vera ◽  
Delayed Diagnosis ◽  
Janus Kinase ◽  
Cerebellar Hemisphere ◽  
Cerebellar Tumor ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
V617f Mutation

Abstract Background Cerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon. Case presentation This report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation. Conclusion Isolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.

Isolated cortical vein thrombosis in a patient with sickle cell disease: Treatment with decompressive craniotomy and anticoagulation and literature review

2013 ◽  
Vol 61 (2) ◽  
pp. 173 ◽  
Author(s):  
PedroTadao Hamamoto Filho ◽  
RobertoColichio Gabarra ◽  
GabrielPereira Braga ◽  
LucileneSilva Ruiz e Resende ◽  
Rodrigo Bazan ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Literature Review ◽  
Sickle Cell ◽  
Cell Disease ◽  
Disease Treatment ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Decompressive Craniotomy ◽  
Cortical Vein Thrombosis

scholarly journals Malignant isolated cortical vein thrombosis with type II protein S deficiency: a case report

BMC Neurology ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Nobuhiko Arai ◽  
Masanao Tabuse ◽  
Akiyoshi Nakamura ◽  
Hiromichi Miyazaki
Keyword(s):  
Case Report ◽  
Protein S ◽  
Type Ii ◽  
Protein S Deficiency ◽  
Cortical Vein ◽  
Vein Thrombosis ◽  
Cortical Vein Thrombosis ◽  
S Deficiency

scholarly journals Ibuprofen-related renal tubular acidosis in pregnancy

2011 ◽  
Vol 4 (3) ◽  
pp. 122-124 ◽  
Author(s):  
Andrew Mallett ◽  
Matthew Lynch ◽  
George T John ◽  
Helen Healy ◽  
Karin Lust
Keyword(s):  
Renal Dysfunction ◽  
Renal Tubular Acidosis ◽  
History Taking ◽  
Third Trimester ◽  
The Third ◽  
Healthy Neonate ◽  
Renal Tubular ◽  
In Pregnancy

Ibuprofen-related renal tubular acidosis (RTA) has not been previously described in pregnancy but its occurrence outside of pregnancy is being increasingly described. In this case, a 34-year-old woman presented in the third trimester of pregnancy with Type 1 or distal RTA related to ibuprofen and codeine abuse. It was complicated by acute on chronic renal dysfunction and hypokalemia. Delivery at 37 weeks gestation due to concerns of evolving preeclampsia resulted in the birth of a healthy neonate. RTA and hypokalemia were remediated and ibuprofen and codeine abuse ceased. Some renal dysfunction however continued. Thorough and repeated history taking as well as vigilance for this condition is suggested.

The renin-aldosterone system in pre-eclampsia, essential and transient hypertension during pregnancy, and normotensive pregnant and non-pregnant control subjects

1982 ◽  
Vol 101 (2) ◽  
pp. 273-280 ◽  
Author(s):  
E. B. Pedersen ◽  
A. B. Rasmussen ◽  
P. Johannesen ◽  
H. J. Kornerup ◽  
S. Kristensen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin ◽  
Urinary Sodium Excretion ◽  
Third Trimester ◽  
Plasma Aldosterone Concentration ◽  
The Third ◽  
Control Subjects ◽  
Hypertension In Pregnancy ◽  
Normotensive Pregnancy ◽  
In Pregnancy

Abstract. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), and blood pressure were determined in the third trimester in pregnancy, 5 days and 6 months after delivery in pre-eclampsia, essential and transient hypertension in pregnancy and in normotensive pregnant and non-pregnant control subjects. PRC and PAC were elevated several fold above non-pregnant level in all groups during pregnancy. In pre-eclampsia PRC and PAC were 220 and 160%, respectively, above the levels 6 months after delivery, and thus lower than the corresponding values, 360 and 402%, in normotensive pregnancy. In essential and transient hypertension PRC and PAC increased to the same degree as during normotensive pregnancy. Urinary sodium excretion, serum sodium and creatinine clearance were reduced in pre-eclampsia, but not in essential and transient hypertension when compared to normotensive pregnant controls. All the parameters determined were the same as in non-pregnant controls 6 months after delivery in all groups. There were no correlations between blood pressure and PRC or PAC in any of the groups neither in pregnancy nor after delivery. It is concluded that the renin-aldosterone system is stimulated in lesser degree in pre-eclampsia than in both essential hypertension, transient hypertension and normotensive pregnancy, and there was no evidence for a causal relationship between the renin-aldosterone system and blood pressure neither in normotensive nor hypertensive pregnancy.

scholarly journals DESENHO DA GRAVIDEZ E SENSIBILIDADE SONORA: CONTRIBUTOS PARA O ESTUDO DA PSICOLOGIA DA GRAVIDEZ

2016 ◽  
Vol 1 (1) ◽  
pp. 25
Author(s):  
Mª Eduarda Salgado Carvalho ◽  
Joao Manuel Rosado de Miranda Justo
Keyword(s):  
Longitudinal Study ◽  
Graphical Representation ◽  
Third Trimester ◽  
Psychological Study ◽  
Portuguese Version ◽  
The Third ◽  
Projective Measures ◽  
Music Representations ◽  
Maternal Orientation ◽  
In Pregnancy

Resumo.Introdução: Esta comunicação pretende descrever um estudo longitudinal acerca da aplicação da Escala do Desenho da Gravidez e da Escala da Sensibilidade Sonora-Musical na Gravidez, ambas construídas e validadas para este estudo, numa amostra de 211 mulheres grávidas aguardando a realização das ecografias do II e do III trimestres de gestação. Objectivos: 1) avaliar a evolução das variáveis do desenho da gravidez e das variáveis sonoro-musicais na passagem do II para o III trimestre e 2) analisar a contribuição de cada uma de estas variáveis para o estudo da psicologia da gravidez. Método: 1) estudo longitudinal comparando as variáveis do desenho da gravidez e a sensibilidade sonoro-musical observadas nos dois momentos de avaliação; 2) estudo correlacional entre cada uma destas variáveis e as variáveis de vinculação materna pré-natal e de orientação materna pré-natal. Instrumentos: Escala do Desenho da Gravidez (Carvalho, 2011), Escala da Sensibilidade Sonora-Musical na Gravidez (Carvalho & Justo, 2013), Escala de Vinculação Materna Pré-natal (versão Portuguesa, Camarneiro & Justo, 2010) e Questionário do Paradigma Placentário (versão portuguesa, Carvalho, 2011). Resultados: Os resultados revelam a existência de diferenças significativas, entre o II e o III trimestres nas variáveis estudadas, apontando para: a) um aumento da sensibilidade sonoro-musical no terceiro trimestre, b) uma evolução da auto-representação da imagem materna no terceiro trimestre e c) um aumento da frequência de representação gráfica da posição de apresentação fetal cefálica da imagem do bebé na passagem para o terceiro trimestre. Observaram-se correlações significativas entre, por um lado, as variáveis da sensibilidade sonoro-musical e as variáveis do desenho da gravidez e, por outro lado, as variáveis de orientação materna pré-natal. Registaram-se correlações significativas entre sensibilidade sonoro-musical, por um lado, e vinculação materna pré-natal e a orientação maternal pré-natal, por outro. Conclusão: Será importante investigar a dialética entre a representação do bebé imaginado através de medidas projectivas maternas e a percepção do comportamento fetal recorrendo à observação ecográfica e a medidas biofísicas e hemodinâmicas.Palavras chave: Gravidez, Escala do Desenho da Gravidez, Escala das Representações Sonoro-Musicais na Gravidez, Escala de Vinculação Materna Pré-Natal, Questionário do Paradigma Placentário.Abstract.Background: This paper aims to describe a longitudinal study about the use of the Drawing Pregnancy Scale and of the Sound-Music Representations in Pregnancy Scale, both of it created and validated in a sample of 211 pregnant women while waiting for sonograms of the II and III trimesters of pregnancy. Aims: 1) to assess, the evolution of variables in drawings of pregnancy and also of sound-music variables, by the transition of the II to the III trimester of gestation and 2) to analyze the contribution of each one of these variables for the psychological study of pregnancy. Method: 1) longitudinal study comparing variables in drawings of pregnancy and sound-music variables at the two moments of assessment; 2) correlational study between each one of these variables and variables of maternal pre-natal attachment and also of maternal pre-natal orientation. Instruments: Drawing Pregnancy Scale (Carvalho, 2011), Sound-Music Representations in Pregnancy Scale (Carvalho & Justo, 2013), Maternal Pre-natal Attachment Scale (Portuguese version, Camarneiro & Justo, 2010) and Placental Paradigm Questionnaire (Portuguese version, Carvalho, 2011). Results: Results show the existence of significant diferences between the II and the III trimestres in some of the variables under analysis, suggesting: a) a increase of the sound-music sensibility by the third trimester, b) an evolution of the maternal image at the third trimester and c) an increase of the frequency of the graphical representation of the cephalic fetal presentation of the baby’s image at the third trimester. Significant correlations were observed between, on one side, the variables of soundmusic sensibility and the variables of the pregnancy drawings and, on another side, variables of prenatal maternal orientation. Significant correlations between sound-music sensibility, on one side, and prenatal maternal attachment and prenatal maternal orientation, on the other side, were found. Conclusion: It will be important to investigate about the representation of the imagined baby through maternal projective measures and the perception of fetal behaviour using sonograms as well as biophysical and hemodynamic measures.Keywords: Pregnancy, Drawing Pregnancy Scale, Sound-Music Representations in Pregnancy Scale, Maternal Pre-natal Attachment Scale, Placental Paradigm Questionnaire.

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