1/17. Idiopathic intracranial haemorrhage in the fetus.Intracranial haemorrhage in the fetus has been reported with associated mortality and morbidity. This case report describes idiopathic subdural haematomas diagnosed at 32 weeks of gestation, with delivery by caesarean section of a live male infant in good condition at 34 weeks.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/17. prenatal diagnosis of a subdural hematoma associated with reverse flow in the middle cerebral artery: case report and literature review.To our knowledge this is the first reported case of a subdural hematoma, related to fetal autoimmune thrombocytopenia, diagnosed prenatally by ultrasound. The underlying etiology was hidden maternal autoimmune thrombocytopenia. This disease, which is as serious as alloimmune thrombocytopenia, causes severe fetal thrombocytopenia, which carries with it a high risk of intracranial hemorrhage and recurrence in subsequent pregnancies. Only 14 cases of fetal subdural hematomas have been reported in the literature. The etiologies of these cases were principally traumatic, or due to disorders of hemostasis. Their prognoses were generally poor, with 50% resulting in fetal death in utero and the remaining 50% demonstrating post-natal sequelae. The presence of reverse flow in the middle cerebral artery is rare and its association with a subdural hematoma unusual. Abnormalities found on cerebral Doppler studies indicate an adaptive response to a fetal condition for which the prognosis is then very poor. Monitoring fetuses at risk for hemorrhage by ultrasound imaging and Doppler studies enables us to detect indicators of a worsening prognosis before the ultrasound appearance of morphological hemorrhage. The development of intracranial hemorrhage raises difficult management issues during the index pregnancy and in subsequent pregnancies.- - - - - - - - - - ranking = 0.16565078118641keywords = pregnancy (Clic here for more details about this article) |
3/17. Active crohn disease with maternal vitamin k deficiency and fetal subdural hematoma.BACKGROUND: Fetal subdural hematoma is a rare condition not considered a complication of crohn disease in pregnancy. CASE: A young woman with a diagnosis of crohn disease presented at 22 weeks' gestation with diarrhea and melena for 3 weeks. Dietary and medicinal therapies were begun. At 28 weeks' gestation, fetal ultrasonography showed an intracranial mass, which was seen to expand on serial ultrasound and magnetic resonance imaging studies. A hematoma was suspected, and, although the mother had no overt hemorrhagic manifestations, maternal vitamin k deficiency was diagnosed by enzyme immunoassay and corrected. After cesarean delivery at 36 weeks' gestation, the newborn was normal, but magnetic resonance imaging showed a chronic subdural hematoma. CONCLUSION: Maternal vitamin k deficiency in active crohn disease might cause fetal hemorrhage. Monitoring of vitamin K status during pregnancy with crohn disease seems warranted.- - - - - - - - - - ranking = 3.3313015623728keywords = gestation, pregnancy (Clic here for more details about this article) |
4/17. prenatal diagnosis of an infratentorial subdural hemorrhage: case report.We report a case of a prenatally diagnosed infratentorial subdural hemorrhage. The hematoma located in the posterior cerebral fossa was detected by conventional ultrasound at 24 weeks of gestation. Intrauterine magnetic resonance imaging confirmed the diagnosis. autopsy of the fetus revealed a well-circumscribed subdural hematoma. The prenatal findings of intracranial bleeding located in the posterior fossa and the prognosis of such cases are discussed.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
5/17. Nontraumatic spinal subdural haematoma occurring in a postpartum period.Spontaneous occurrence of spinal subdural haematoma (SSH) is very rare. While many neurological disorders can develop in pregnant patients in relation to haemostatic imbalance, there have been no reports in the literature suggesting that pregnancy and/or childbirth per se could be a single risk factor for acute SSH.A 38-year-old previously healthy woman gave birth to a baby via transvaginal normal delivery. The patient had no history of receiving anticoagulants. Eight days after delivery, she experienced sudden onset severe interscapular back pain, and the next day she developed dysesthesia in the both legs and mild urinary retention. Severe meningeal signs were noted. Lumbar puncture revealed bloody cerebrospinal fluid. Magnetic resonance images revealed SSH in the ventral position spreading from levels Th1 to Th7. The patient underwent conservative treatment after which the symptoms gradually improved. Serial MRI study at 17 and 69 days after onset showed spontaneous regression of the SSH. Spinal angiography did not show any vascular malformations, but simultaneous cerebral angiography revealed a co-existing cerebral aneurysm on the C2 segment of the left internal carotid artery. It is unlikely that the cerebral aneurysm was the origin of the SSH, based on the clinical and radiographic findings. Moreover, we confirmed the unruptured nature of the aneurysm during the clipping procedure at open surgery.We report the unique case of subacute SSH occurring 8 days after childbirth without other known risk factors. The possible etiology and magnetic resonance imaging (MRI) findings in this case, and the current controversy concerning therapy for SSH are discussed.- - - - - - - - - - ranking = 0.16565078118641keywords = pregnancy (Clic here for more details about this article) |
6/17. Maternal total parenteral nutrition and fetal subdural hematoma.BACKGROUND: Fetal subdural hematoma is rare, and no case resulting from vitamin k deficiency secondary to maternal total parenteral nutrition has been reported. CASE: A 28-year-old woman was managed with total parenteral nutrition from 28 weeks' gestation because of continuous vomiting due to esophageal hiatal hernia. A sinusoidal pattern by cardiotocogram was observed at 31 weeks' gestation. Serial sonograms showed a fetal subdural hematoma, and cesarean delivery was performed. Although the maternal hepaplastin test result was normal and the maternal PIVKA-II concentration was only slightly elevated, the neonate was severely anemic and had severe vitamin k deficiency. CONCLUSION: Severe fetal vitamin k deficiency can develop even when the maternal deficiency is mild. When maternal total parenteral nutrition is necessary, supplemental vitamin K should be administered.- - - - - - - - - - ranking = 2keywords = gestation (Clic here for more details about this article) |
7/17. prenatal diagnosis of atraumatic fetal subdural hematoma.We present a case of atraumatic subdural hematoma diagnosed by ultrasound at 22 weeks. A hyperechogenic round mass was identified in the posterior fossa. Further investigation with fetal brain magnetic resonance imaging confirmed the diagnosis. After medical consultation, the parents opted for pregnancy termination. The pathology report confirmed the ultrasonographic and magnetic resonance imaging diagnosis.- - - - - - - - - - ranking = 0.16565078118641keywords = pregnancy (Clic here for more details about this article) |
8/17. Second-trimester diagnosis of intracranial vascular anomalies in a fetus with subdural hemorrhage.OBJECTIVES: risk factors for intracranial hemorrhage occurring in prenatal life are imperfectly known. A case of prenatal diagnosis of subdural hemorrhage associated with multiple intracranial vascular aneurysms is described. methods: Sonography and magnetic resonance imaging of the fetal head were obtained at 21 weeks' gestation and compared with pathologic findings. RESULTS: Sonography showed a large transonic mass displacing the normal intracranial structures. magnetic resonance imaging demonstrated the hemorrhagic origin of the mass and showed multiple vascular anomalies. Postmortem examination confirmed the compression of the cerebral hemisphere by a blood collection, probably because of bleeding from one of the multiple vascular aneurysms into the subdural space. CONCLUSION: magnetic resonance imaging with the use of single-shot ultrafast sequences may be useful not only in the differential diagnosis of fetal intracranial hemorrhage but also in identifying vascular risk factors.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
9/17. Advanced gastric cancer and a concomitant pregnancy associated with disseminated intravascular coagulation.Gastric cancer associated with pregnancy is extremely rare and the prognosis is generally grave. A 31-year-old Japanese women, 41 weeks pregnant, displayed disseminated intravascular coagulation (DIC), although clinical symptoms and diagnostic examinations did not indicate an obstetrical cause. She went into labor spontaneously and vaginally delivered a 3248-g normal female infant, after receiving a blood transfusion. On the day 5 postpartum, a gastroduodenal fiberscope examination indicated advanced gastric cancer. She was also diagnosed with bilateral chronic subdural hematoma and underwent an operation to allow drainage. It was not possible to treat her curatively, so she was treated conservatively for DIC. She died on day 13 postpartum. Necropsy of the iliac bone indicated bone marrow metastasis of adenocarcinoma. This is the first known case of a pregnant woman with DIC occurring as the first manifestation of advanced gastric cancer.- - - - - - - - - - ranking = 0.82825390593204keywords = pregnancy (Clic here for more details about this article) |
10/17. Acute subdural haematoma after accidental dural puncture during epidural anaesthesia.A case is reported of acute intracranial subdural haematoma following accidental dural puncture during epidural anaesthesia. A 36-year-old primigravida with a gestation of 37 weeks and 3 days underwent caesarean section for which epidural anaesthesia was initially planned. An 18-gauge Tuohy needle was inserted into the L3-4 interspace but accidental dural puncture occurred. The needle was removed and general anaesthesia was initiated for surgery. On the second day post partum, the patient described a headache in both occipital area and neck that was relieved by lying down. On the seventh post-partum day she suffered tonic-clonic convulsions and underwent computerised tomography (CT). Despite different analgesic treatments and a normal CT, the patient suffered severe headaches in the following days. magnetic resonance imaging revealed a 4-mm subdural hematoma in the right frontal area. The persisting headache decreased on day 12 and disappeared on day 14. The patient was discharged from hospital on day 15. The presence of post dural puncture headache complicated by atypical neurological deterioration following epidural anaesthesia should prompt the anaesthetist to consider the existence of intracranial complications and to seek immediate clinical and radiological diagnosis.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
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