Primary Cesarean Delivery Complicated by the Incidental Finding of a Cerebral Aneurysm: Selecting a Safe Anesthesia Technique

Abstract

The presence of a cerebral aneurysm in an obstetric patient raises a special anesthetic concern for cesarean delivery. General anesthesia poses the inherently increased risk of a difficult airway as well as an adverse impact of hypertension during induction and emergence. Epidural anesthesia may facilitate gradual hemodynamic changes and allows intraoperative neurologic monitoring. However, potential dural puncture headache may lender it difficult to recognize an intracranial hemorrhage. In the end, spinal anesthesia was chosen for the advantage of avoiding hypertensive responses from either airway stimulation or inadequate analgesia.