妊娠期特发性颅内高压的麻醉处理。病例报告。

D Revuelta, M López-Baamonde, M Vendrell, A Plaza, T Cobo, M Magaldi
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引用次数: 0

摘要

特发性颅内高压(IIH)是一种以病因不明的颅内压(ICP)升高为特征的疾病,多发于肥胖的育龄妇女。妊娠期 IIH 的治疗是一项多学科挑战,因为药物治疗因胎儿致畸风险而备受争议,而脑室腹腔分流术的技术难度又因妊娠子宫的存在而受到阻碍。分娩过程中麻醉管理的目标是维持血流动力学稳定、脑灌注压和脑组织氧合,同时避免颅内压突然波动。麻醉技术的选择非常复杂,取决于对每种技术相关风险和益处的评估,涉及神经麻醉和全身麻醉之间的抉择。我们介绍了一例进展迅速的 IIH 孕妇病例,该病例采用了多学科方法,其麻醉管理在技术上具有挑战性,但结果良好,未出现后续并发症。
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Anesthetic management of idiopathic intracranial hypertension during pregnancy. A case report.

Idiopathic intracranial hypertension (IIH) is a condition characterized by elevated intracranial pressure (ICP) of unknown etiology, more prevalent in obese women of childbearing age. The management of IIH during pregnancy represents a multidisciplinary challenge, as medical treatment is contentious due to the foetal teratogenic risk, and the technically challenging placement of a ventriculoperitoneal shunt is hindered by the presence of the pregnant uterus. The goal of anaesthetic management during childbirth is to maintain hemodynamic stability, cerebral perfusion pressure, and cerebral tissue oxygenation, while avoiding abrupt fluctuations in intracranial pressure. The choice of anaesthetic technique is complex and depends on the assessment of risks and benefits associated with each technique, involving a decision between neuraxial anaesthesia and general anaesthesia. We present the case of a pregnant woman with rapidly progressing IIH, approached in a multidisciplinary manner, whose anaesthetic management was technically challenging, resulting in a favourable outcome without subsequent complications.

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