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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Hemorrhagic moyamoya disease during pregnancy.
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Hemorrhagic moyamoya disease during pregnancy.

机译：孕期出血性烟雾病。

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BACKGROUND: Intracranial hemorrhage in pregnant patients with Moyamoya disease is rare. We review the case of one such patient who presented with pre-eclampsia and a catastrophic intracerebral hemorrhage in order to highlight the associated management difficulties. METHODS: A case of a pregnant (31 weeks) female brought to the emergency department with hypertension and a progressive decrease in her level of consciousness is presented. She rapidly developed a dilated right pupil and left extensor posturing. A CT scan of her head showed a large putamenal intracerebral hemorrhage. She was intubated, ventilated and given intravenous mannitol and magnesium sulfate. She underwent a simultaneous craniotomy and Cesarean section. Post-operatively the patient's ICP and jugular venous saturation were monitored in the intensive care unit. RESULTS: The patient delivered a 1185 g infant who did well. The patient's ICP was well controlled until the tenth post-operative day when she developed malignant brain edema and died. CONCLUSION: This case highlights three important points. First, simultaneous craniotomy and Cesarean section can be performed. Second, intraoperative control of bleeding Moyamoya vessels is described. Third, the difficult post-operative management of these cases is highlighted. The literature regarding Moyamoya disease and pregnancy is reviewed and some recommendations for the management of this rare but potentially deadly condition are presented.
机译：背景：烟雾病孕妇的颅内出血很少见。我们回顾了一名患有先兆子痫和灾难性脑出血的患者，以突出相关的管理困难。方法：有一例孕妇（31周）因高血压被送往急诊科，其意识水平逐渐下降。她迅速发展为右瞳孔扩张和左伸肌姿势。她头部的CT扫描显示大的put状脑内出血。给她插管，通气并给予静脉甘露醇和硫酸镁。她同时进行了开颅手术和剖宫产。术后在重症监护室监测患者的ICP和颈静脉饱和度。结果：该患者分娩出1185 g婴儿，状况良好。患者的ICP一直得到良好控制，直到术后第十天出现恶性脑水肿并死亡。结论：该案例突出了三个要点。首先，可以同时进行开颅手术和剖宫产。其次，描述了对Moyamoya血管出血的术中控制。第三，突出了这些病例的术后管理困难。评论有关烟雾病和怀孕的文献，并提出了一些处理这种罕见但可能致命的疾病的建议。

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