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Case Reports
. 2012:3:65.
doi: 10.4103/2152-7806.97167. Epub 2012 Jun 19.

Complete recovery after antepartum massive intracerebral hemorrhage in an atypical case of sudden eclampsia

Ramsis F Ghaly  1 , Kenneth D Candido, Ruben Sauer, Nebojsa Nick Knezevic
Affiliations
Case Reports

Complete recovery after antepartum massive intracerebral hemorrhage in an atypical case of sudden eclampsia

Ramsis F Ghaly et al. Surg Neurol Int. 2012.

Abstract

Background: Intracerebral hemorrhage is an infrequent but severe complication in pregnant women with hypertension.

Case description: We describe an atypical case of a patient with no risk factors who developed sudden eclampsia and spontaneous intracerebral hemorrhage during the 34(th) week of pregnancy. She underwent successful emergent Cesarean section followed by craniotomy. Both intraoperative surveillance and postoperative magnetic resonance angiographic examination of the cerebral vessels failed to identify an aneurysm, arteriovenous malformation, tumor, or leptomeningeal disease.

Conclusion: We discuss the management of this case and review the literature regarding the threshold for which initiation of antihypertensive treatment is indicated in pregnant patients.

Keywords: Eclampsia; intracerebral hemorrhage; pregnancy.

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Figures

Figure 1
Figure 1
Pre-operative CT scans of the head (a) axial view showing dissecting intraparenhymal right frontal hematoma and absence of brain sulci indicating extensive brain swelling (b) axial view showing extensive intraventricular hemorrhage, 1 cm midline shift, subarachnoid hemorrhage and brain swelling (c) axial view showing 4th ventricular hemorrhage and prominence of temporal ventricular horns indicating obstruction
Figure 2
Figure 2
Post-operative CT scans of the head (a) axial view showing resolution of ventricular and cerebral hemorrhage, placement of right intraventricular drain and resolution of midline shift (b) axial view represents successful resolution of dissecting evacuation of right frontal intracerebral hemorrhage
Figure 3
Figure 3
Postoperative magnetic resonance angiography demonstrating no brain aneurysm and disruption of regional blood–brain barrier at the site of hematoma
See this image and copyright information in PMC

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