Case Reports in Anesthesiology · Published 2025-01-01 · DOI 10.1155/cria/2681007
Unruptured cerebral aneurysms during pregnancy carry a high risk of rupture in late gestation. Simultaneous cesarean section and aneurysm clipping are rare and demand careful anesthetic planning. A 34-year-old woman at 36-week gestation presented with progressive oculomotor palsy caused by an unruptured 8-mm cerebral aneurysm. A sequential cesarean delivery, followed by aneurysm clipping, was planned. Spinal anesthesia was used for cesarean section to minimize fetal sedation and then converted to general anesthesia for neurosurgery. Transmural aneurysmal pressure (TAP) was maintained by avoiding mean arterial pressure surges and excessive intracranial pressure reduction. The procedure was uneventful, and both the mother and neonate recovered without any complications. This case highlights the importance of multidisciplinary planning and TAP-guided hemodynamic control in achieving favorable maternal and fetal outcomes in high-risk pregnancies.
Abstract from DOAJ. Public domain (CC0 1.0).
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