妊娠期动静脉畸形相关头痛和癫痫发作伪装成子痫：病例报告

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2024-07-01 DOI:10.1016/j.tjog.2023.09.026

Siou-Ting Lee , Yi-Liang Lee , Ya-Che Chen , Wei Lin , Ching-I Wu , Chi-Kang Lin

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引用次数: 0

摘要

目的妊娠期脑动静脉畸形是一种罕见但致命的疾病，通常表现为模仿子痫的新发癫痫发作和头痛。我们报告了一例罕见的脑动静脉畸形病例，患者在妊娠三个月时突然出现癫痫发作。病例报告一名 28 岁的初产妇在妊娠 32 6/7 周时因新发急性癫痫发作和高血压被送到我院急诊科。由于神经系统恶化，患者接受了紧急剖宫产。然而，在剖宫产和子痫治疗 24 小时后，癫痫发作加剧。计算机断层扫描和磁共振成像显示右额叶动静脉畸形未破裂。随后，进行了动脉内栓塞术。本病例报告强调了产科医生和急诊科医生对妊娠晚期突然新发癫痫发作的鉴别诊断。除子痫外，在妊娠期间还应考虑致命的脑部疾病。

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Arteriovenous malformation-related headache and seizures in pregnancy masquerading as eclampsia: A case report

Objective

Cerebral arteriovenous malformation during pregnancy is rare but lethal disease that usually present with new-onset seizures and headaches mimicking eclampsia. We report a rare case of cerebral arteriovenous malformation with abrupt seizures in the third trimester.

Case Report

A 28-year-old primipara was brought to our emergency department at 32 6/7 weeks of gestation with new-onset acute seizures and hypertension. Owing to neurological deterioration, the patient underwent emergency cesarean delivery. However, 24 h after cesarean delivery and eclampsia treatment, the seizures worsened. Computed tomography and magnetic resonance imaging showed unruptured arteriovenous malformation of the right frontal lobe. Subsequently, intraarterial embolization was performed. The patient was discharged 5 days after surgery without neurological sequelae or obstetric complications.

Conclusion

This case report highlights the differential diagnoses of sudden new-onset seizures in late pregnancy for obstetricians and emergency medicine physicians. Lethal cerebral diseases, apart from eclampsia, should be considered during pregnancy.

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.

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