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Vol. 67. Issue 4.
Pages 204-207 (April 2020)
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Vol. 67. Issue 4.
Pages 204-207 (April 2020)
Case report
DOI: 10.1016/j.redare.2019.11.006
Anaesthetic management of intracranial hypertension and pregnancy. A case report
Manejo anestésico de hipertensión intracraneal y embarazo. Informe de un caso
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A. Sampaio
Corresponding author
anasssampaio@gmail.com

Corresponding author.
, G. Norte, M.J. Campos, A. Raimundo, C. Carreira, R. Órfão
Servicio de Anestesiología, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Abstract

Hydrocephalus is an active distension of the ventricular system of the brain. The improved survival rates of patients with neurosurgical pathology is accompanied by a greater number of non-neurosurgical procedures in patients who have therapeutic neurosurgical devices.

The real incidence of pregnancy in patients with obstructive hydrocephalus controlled with ventriculoperitoneal shunt (VPS) is unclear.

We present a case of a pregnant 34-year-old female with a VPS for obstructive hydrocephalus. Due to VPS obstruction secondary to uterus volume, she presented several episodes of neurological impairment during pregnancy. An elective caesarean section (C-section) and VPS review were planned for the same operative time.

This rare case reflects the challenge that the anaesthesiologist has to face in order to provide the best and simultaneous management of the wellbeing of the mother, the mother's brain and the foetus.

Keywords:
Neurosurgery
Brain
Intracranial hypertension
Hydrocephalus
Prostheses and implants
Ventriculoperitoneal shunt
Pregnancy
Resumen

La hidrocefalia es una distensión activa del sistema ventricular del cerebro. Las mejores tasas de supervivencia de los pacientes con enfermedad neuroquirúrgica se acompañan de un mayor número de procedimientos no neuroquirúrgicos en pacientes que tienen dispositivos neuroquirúrgicos terapéuticos.

No está clara la verdadera incidencia del embarazo en pacientes con hidrocefalia obstructiva controlada con derivación ventriculoperitoneal (DVP).

Presentamos un caso de una mujer embarazada de 34 años con una DVP para hidrocefalia obstructiva. Debido a la obstrucción de la DVP secundaria al volumen del útero, ella presentó varios episodios de deterioro neurológico durante el embarazo. Se planificaron una cesárea electiva y una revisión de la DVP para el mismo tiempo operatorio.

Este caso inusual representa un desafío al que el anestesiólogo debe enfrentarse para proporcionar el mejor manejo simultáneo del delicado bienestar de la madre, su cerebro, y el feto.

Palabras clave:
Neurocirugía
Cerebro
Hipertensión intracraneal
Hidrocefalia
Prótesis e implantes
Derivación ventriculoperitoneal
Embarazo

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