1/2. Successful brainstem cavernous malformation resection after repeated hemorrhages during pregnancy.BACKGROUND: pregnancy may be a risk factor for aggressive behavior in cavernous malformations. Relatively few cases exist in the literature and management is unclear. methods: This unique case report describes a 28-year-old female 27 weeks pregnant who presented with 2 hemorrhages from a pontine cavernous malformation within 1 week. morbidity increased with the second hemorrhage. RESULTS: The patient underwent a suboccipital craniotomy and excision of the cavernous malformation. She successfully delivered a normal child at 36 weeks gestation and is ambulatory and independent 3 months postoperatively. CONCLUSIONS: pregnancy and prior hemorrhage may be risk factors for repeated hemorrhages. Management decisions can be difficult during pregnancy, but successful excision during pregnancy is possible. The behavior of cavernous malformations and management decisions for this patient are discussed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/2. hemorrhage of cavernous malformations during pregnancy and in the peripartum period: causal or coincidence? Case report and review of the literature.There is growing evidence to suggest that pregnancy may increase the risk of hemorrhage from cavernous malformations (CMs). In the present case, a 21-year-old primigravida was admitted to the authors' neurosurgical service after a cesarean section. Three weeks before admission she had experienced rapidly progressive bilateral lower-extremity paresthesias. Spinal magnetic resonance (MR) imaging revealed the presence of an intramedullary thoracic lesion. On T2-weighted MR images, heterogeneous signal intensity with a rim of decreased intensity was demonstrated in the spine. The mass was successfully resected, and 1 year later the patient's symptoms had resolved completely. This is the fourth reported case of a spinal intramedullary CM that became symptomatic during pregnancy. The pathogenesis and management of this entity are reviewed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |