A Case of Anesthetic Management for a Pregnant Woman with Unruptured Cerebral Aneurysm Undergoing Simultaneous Cesarean Section and Aneurysm Clipping: A case report

1999 ◽  
Vol 36 (4) ◽  
pp. 736
Author(s):  
Chong Doo Park ◽  
Soung Moon Han ◽  
Chong Soo Kim
Author(s):  
Seong Shin Kim ◽  
Byung Gun Lim ◽  
Seok Kyeong Oh ◽  
Jae Hak Lee

Patients with multiple drug allergies (MDA) can be in danger during anesthesia due to their possibility of anaphylaxis. Perioperative anaphylaxis can occur more frequently in patients with any kind of allergic history. The physiological changes during pregnancy, the existence of the fetus itself, and consequent restrictions on drug use including anesthetics make anesthetic management for pregnant women with MDA more difficult than that for other patients. Appropriate anesthetic strategy based on detailed history taking, allergological evaluations and cooperation between surgeon and anesthesiologist are essential to performing successful anesthesia. To the best of our knowledge, although there have been some cases about anesthetic management in patients with MDA, there is no reported case about surgical anesthesia for Cesarean section in a pregnant woman with MDA. Here, we present a pregnant woman with MDA who showed a positive response to most of anesthetics and analgesics in the intradermal skin test, successfully managed with an anesthetic strategy using volatile induction and maintenance anesthesia (VIMA) for Cesarean section.


Author(s):  
Yaling Liu ◽  

Introduction: Acute brain herniation is a life-threatening neurological condition that occasionally develops due to severe complications following cerebral aneurysm clipping. Strategies for managing acute brain herniation have not improved substantially during the past decade. Hyperbaric oxygen treatment (HBOT) may alleviate harmful effects of cerebral hypoxia, which is one of the most important pathophysiological features of acute brain herniation and, therefore, may be useful as an adjuvant therapy for acute brain herniation. A case treated with adjuvant HBOT is reported. Case report: A 60-year-old asymptomatic man presented with a recurring left middle cerebral artery bifurcation aneurysm with previous stent-assisted embolisation. After craniotomy for surgical clipping of the aneurysm, disturbance of consciousness and right hemiplegia occurred. Computed tomography (CT) images suggested simultaneous cerebral ischaemia and intracranial haemorrhage. Pharmacologic treatment resulted in no improvement. A CT scan acquired five days after surgery showed uncal and falcine herniation. HBOT was administered five days after surgery, and the patient’s condition dramatically improved. He became conscious, and his hemiplegia improved following seven sessions of HBOT. Simultaneously, CT images showed regression of the acute brain herniation. Conclusions: The patient had recovered completely at one year post-treatment. HBOT may be effective in the treatment of acute brain herniation following cerebral aneurysm clipping.


Author(s):  
Recep Erin ◽  
Kübra Baki Erin ◽  
Derya Burkankulu Ağırbaş ◽  
Burcu Kemal Okatan

<p>We aimed to present a case with abdominal wall endometriosis following cesarean section in this case report. <br />A 32 year old 39 weeks pregnant woman with G2P1 was admitted to gynaecology clinic with abdominal lump and pain in the midline. Her physical examination included a hard and painful palpable subcutaneous mass of 4x5 cm size in the midline of the abdomen which was semisolid and irreducible. <br />Under general anesthesia, the mass on the rectus muscle was excised with the healthy tissue around with the diagnosis of endometriosis during cesarean section and the pathological diagnosis was reported as endometriosis.<br />Surgical excision is the best treatment method in abdominal wall endometriosis. <br /><br /></p>


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