Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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

References

    1. Bateman BT, Schumacher HC, Bushnell CD, Pile-Spellman J, Simpson LL, Sacco RL, et al. Intracerebral hemorrhage in pregnancy: Frequency, risk factors, and outcome. Neurology. 2006;67:424–9. - PubMed
    1. Bousser MG. Stroke in women: The 1997 Paul Dudley White International Lecture. Circulation. 1999;99:463–7. - PubMed
    1. Chang L, Looi-Lyons L, Bartosik L, Tindal S. Anesthesia for cesarean section in two patients with brain tumors. Can J Anesth. 1999;46:61–5. - PubMed
    1. Dai X, Diamond JA. Intracerebral hemorrhage: A life-threatening complication of hypertension during pregnancy. J Clin Hypertens (Greenwich) 2007;9:897–900. - PMC - PubMed
    1. Davie CA, O’Brien P. Stroke and pregnancy. J Neurol Neurosurg Psychiatry. 2008;79:240–5. - PubMed

Publication types