Treatment of a giant arteriovenous malformation associated with intracranial aneurysm rupture during pregnancy: A case report

Chen, Junhui; Wang, Yuhai; Li, Peipei; Chen, Wei‐Liang; Zhou, Jingxu; Hu, Xu; Zhu, Jie; Jiang, Bingjie

doi:10.3892/etm.2016.3505

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Most of the cases reported in the literature related to intracerebral hemorrhage in pregnancy had association with arteriovenous malformation (AVM). Patients with ICH present with persistence of headache or sudden unconsciousness [12,13]. ICH occurring without AVM such as in this case of pregnancy has not yet been reported.…”

Section: Discussionmentioning

confidence: 96%

Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

Winarno¹,

Schloesser²,

Dietzel³

et al. 2019

Clin J Obstet Gynaecol

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Deliveries prior to 28 weeks' gestation (extreme preterm birth) pose a global health concern, according to the World Health Organization (WHO). Extreme preterm birth is associated with several complications in the newborn and management in neonatal intensive care unit would incur high expenses. In parallel, advancements in in vitro fertilization will give an opportunity for women to conceive in cases of ovarian failure. At the same time, health providers also encourage patients to receive more than one embryo simultaneously during an embryo transfer. Here we report a case of a patient in coma condition of triplet pregnancy, post ovum donation with threeembryo transfer. Following stabilization, cranial computed tomography (CCT) was performed. The result showed bleeding in the brainstem and into intraventricular spaces at 25+4 gestation weeks. Furthermore, ICH during pregnancy is considered as a rare case in obstetrical fi eld, especially involving the brainstem. This could lead to life-threatening conditions and serious disability in the future. On the fi fth day of hospitalization, she suffered from pneumonia and pulmonary edema. On the eight day (26+5 gestations weeks), an emergency caesarean section was performed due to fully dilated of the cervix with breech presentation of all fetuses. Mother and the children survived with some non-life-threatening disabilities. This is the very fi rst case reported of intracerebral hemorrhage in the brainstem in triplet pregnancy after receiving ovum donation. Heterologous conception could be an iceberg phenomenon of gestational complications among the population. Reproductive tourism could still become greater in the future.

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Section: Discussionmentioning

confidence: 96%

Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

Winarno¹,

Schloesser²,

Dietzel³

et al. 2019

Clin J Obstet Gynaecol

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“…Our work included four patients with associated vascular anomalies, including AVMs and DVA. The risk of intracranial hemorrhage in patients with coexisted AVM and aneurysm has been reported to be 7% annually, compared with 2%–4% annually for those with AVM alone or isolated intracranial aneurysm[ 31 , 32 ]. To our knowledge, the association between intracranial aneurysms and DVA is infrequent, and few case reports have been published[ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Interobserver reliability of computed tomography angiography in the assessment of ruptured intracranial aneurysm and impact on patient management

Elmokadem,

Elged,

Abdel Razek

et al. 2023

World J Radiol

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BACKGROUND Aneurysmal subarachnoid hemorrhage is an emergency that can lead to a high mortality rate and many severe complications. It is critical to make a rapid radiological evaluation of ruptured intracranial aneurysms (RIAs) to determine the appropriate surgical treatment. AIM To assess the reliability of computed tomography angiography (CTA) in assessing different features of ruptured intracranial aneurysm and its impact on patient management. METHODS The final cohort of this study consisted of 146 patients with RIAs (75 male and 71 female) who underwent cerebral CTA. Their age ranged from 25 to 80, and the mean age ± SD was 57 ± 8.95 years. Two readers were asked to assess different features related to the aneurysm and perianeurysmal environment. Inter-observer agreement was measured using kappa statistics. Imaging data extracted from non-contrast computed tomography and CTA were considered to categorize the study population into two groups according to the recommended therapeutic approach. RESULTS The inter-observer agreement of both reviewers was excellent for the detection of aneurysms (K = 0.95, P = 0.001), aneurysm location (K = 0.98, P = 0.001), and (K = 0.98, P = 0.001), morphology (K = 0.92, P = 0.001) and margins (K = 0.95, P = 0.001). There was an excellent interobserver agreement for the measurement of aneurysm size (K = 0.89, P = 0.001), neck (K = 0.85, P = 0.001), and dome-to-neck ratio (K = 0.98, P = 0.001). There was an excellent inter-observer agreement for the detection of other aneurysm-related features such as thrombosis (K = 0.82, P = 0.001), calcification (K = 1.0, P = 0.001), bony landmark (K = 0.89, P = 0.001) and branch incorporation (K = 0.91, P = 0.001) as well as perianeurysmal findings including vasospasm (K = 0.91, P = 0.001), perianeurysmal cyst (K = 1.0, P = 0.001) and associated vascular lesions (K = 0.83, P = 0.001). Based on imaging features, 87 patients were recommended to have endovascular treatment, while surgery was recommended in 59 patients. 71.2% of the study population underwent the recommended therapy. CONCLUSION CTA is a reproducible promising diagnostic imaging modality for detecting and characterizing cerebral aneurysms.

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Cerebral Arteriovenous Malformations

Mankowitz

2018

Consults in Obstetric Anesthesiology

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Treatment of a giant arteriovenous malformation associated with intracranial aneurysm rupture during pregnancy: A case report

Cited by 4 publications

References 31 publications

Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review

Interobserver reliability of computed tomography angiography in the assessment of ruptured intracranial aneurysm and impact on patient management

Cerebral Arteriovenous Malformations

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