Anaesthetic Management of Traumatic Brain Injury in Pregnancy for Emergency Craniotomy

Abstract

Management of head injury requiring emergency craniotomy in a parturient is indeed challenging. Unexpectedly mild head injury can threaten the life of mother or fetus. A multidisciplinary approach to management which is individualized according to severity of injury and gestational age is appropriate. Neuroanaesthetic approach should strive to provide balance between therapy for mother and risks for fetus. Evidence based recommendations from randomized controlled trials to manage such cases is limited. We report a case of 27 year old woman in late 2nd trimester with extradural and subdural hematoma requiring urgent decompressive craniotomy. Post-operatively, she was managed for two days in the intensive care unit with regular monitoring of Fetal Heart Sound (FHS). Pregnancy continued till term with good outcome of mother and child.