Anesthetic management during cesarean delivery in a pregnant woman with ruptured cerebral arteriovenous malformation: A case report

ABSTRACT

Although intracranial hemorrhage from arteriovenous malformation (AVM) during pregnancy is rare, it can have fatal consequences. Anesthetic techniques for these patients should ensure precise hemodynamic control, and the goals of anesthesia should include both fetal and maternal well-being. We report a case of anesthetic management for cesarean section in a 31-year-old woman who presented at 32 weeks gestation with an acute intracranial hemorrhage secondary to rupture of a previously diagnosed AVM. Our medical team decided to perform emergent cesarean section under regional anesthesia before transferring the patient to the neurosurgical intensive care unit for further monitoring and appropriate postoperative pain control. The patient was alert and cooperative during neuraxial anesthesia. The operation was successful, and the patient showed gradual improvement in neurosurgical status after several days. We concluded that in case of emergency, regional anesthesia can be a safe strategy for cesarean section in a pregnant woman with symptomatic AVM.