A case of postpartum cerebral angiopathy with intracranial hemorrhage in Cesarean delivery: A case report

Lee, Jae woo; Kang, Hyoseok; Lim, Tae Ha; Kim, Eu gene

Case Report

Obstetric Anesthesia

Anesthesia and Pain Medicine 2012;7(4):359-362.
Published online October 31, 2012.

A case of postpartum cerebral angiopathy with intracranial hemorrhage in Cesarean delivery: A case report

Jae woo Lee, Hyoseok Kang, Tae Ha Lim, Eu gene Kim

Department of Anesthesiology and Pain Medicine, Eulji General Hospital, College of Medicine, Eulji University, Seoul, Korea. hskang0108@eulji.ac.kr

Abstract

The occurrence of stroke during pregnancy and the postpartum period is uncommon but is a leading cause of maternal death. Postpartum cerebral angiopathy is one of the causes of the occurrence of stroke during peripartum. A 39-year-old woman with a gestational age of 38 weeks and with uncomplicated pregnancy was admitted to these authors' hospital and was made to undergo emergency Cesarean section under spinal anesthesia due to fetal distress. After the Cesarean delivery, it was found that her state of mind had changed into drowsiness to stupor in the post-anesthetic care unit. The brain computed tomography showed intracranial and subarachnoid hemorrhage. On the cerebral angiography, no aneurysm or arteriovenous malformation was found, except for the focal stenosis of the callosomarginal artery. Emergency decompressive craniectomy was done. After the craniectomy, the patient showed an alert mental status, mild Rt hemiplegia, and slight dysarthria three months after the surgery.

Key Words: Cerebral hemorrhage, Postpartum, Vasculitis, Vasocontriction