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  • Print publication year: 2011
  • Online publication date: May 2011

Case 80 - Cerebralvasospasm

from Section II - Neurocritical care

Summary

Physiologic changes during pregnancy may result in the development or growth of nervous system tumors. Brain tumors tend to become larger during pregnancy due to fluid retention, increased blood volume, and hormonal changes. If the patient is stable, gestational advancement may be permitted into the early second trimester, where surgical management of the tumor can be undertaken. In a patient with worsening symptoms, radiotherapy may be an option to delaying surgery. Patients should be premedicated with a nonparticulate antacid and ranitidine to protect against the sequelae of vomiting and aspiration. Cesarean section in patients with neurologic risk factors. Mechanisms of anesthesia-induced neurotoxicity and selectivity of anesthesia-induced neurodegeneration are actively being investigated. Management of brain tumors in pregnant women is mainly reliant on case reports and inherited wisdom. Therefore, close communication among the neurosurgeon, neuroanesthesiologist, obstetrician, and patient is of paramount importance.

References

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3. J. P. Kistler, R. M. Crowell, K. R. Davis. The relation of cerebral vasospasm to the extent and location of subarachnoid blood visualized by CT scan: a prospective study. Neurology 1983; 33: 424–36.
4. E. M. Manno. Subarachnoid hemorrhage. Neurol Clin 2004; 22: 347–66.
5. N. F. Kassell, S. J. Peerless, Q. J. Durwaed et al. Treatment of ischemic deficits from vasospasm with intravascular volume expansion and induced arterial hypertension. Neurosurgery 1982; 11: 337–43.