title: Ruptured arteriovenous malformation and subarachnoid hemorrhage during emergent cesarean delivery: a case report.
abstract: Cerebral arteriovenous malformations (AVMs) are formed from a vascular plexus of direct arterial-venous connections that progressively dilate, making them prone to rupture. They are frequently asymptomatic and often remain undiagnosed until they present with associated symptoms of headaches, seizures, neurological deficits, or hemorrhages. Occurrence of headache during pregnancy and labor is associated with several diverse etiologies, making definitive diagnosis extremely difficult. This case report describes the anesthetic management of a 31-year-old laboring patient who first complained of headache, then suffered an acute subarachnoid hemorrhage secondary to rupture of a previously undiagnosed AVM during emergent cesarean delivery.
authors.affiliation: United States Naval Hospital, Okinawa, Japan.
authors.forename: Lorraine A
authors.initials: LA
authors.lastname: English
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Mulvey
mesh_terms: D000208:Acute Disease; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods / Q000451:nursing; D002533:Cerebral Angiography; D002585:Cesarean Section; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed