A Case of Anesthetic Management for a Pregnant Woman with Unruptured Cerebral Aneurysm Undergoing Simultaneous Cesarean Section and Aneurysm Clipping: A case report / 대한마취과학회지

ABSTRACT

Intracranial aneurysm in pregnancy imposes special consideration for both mother and fetus. During newborn delivery, the risk of aneurysmal rupture should be avoided by careful management. We experienced a case of cesarean section and the clipping of aneurysm in 37 years old pregnant woman at the gestational age of 35 weeks. She had suffered from headache since 30 weeks of gestational age and the ptosis of left eye since 33 weeks of gestational age. Ten millimeter-sized aneurysm of posterior communicating artery was found on the cerebral angiogram. After radial artery cannulation, we anesthetized the woman with nitroprusside infusion, thiopental, succinylchoine and nitrous oxide-oxygen-isoflurane gas mixture. Soon after intubation, systolic blood pressure increased from 140 to 150 mmHg during the infusion of sodium nitroprusside. The delivery of a newborn was done 8 min after induction and clipping of aneurysm was done successfully after the end of cesarean section.