title: [Cerebral hemorrhage following ovariectomy in a woman undergoing a gamma knife treatment for intracranial arteriovenous malformation].
abstract: We report a case of cerebral hemorrhage following ovariectomy in a 39-year-old woman undergoing a gamma knife treatment for intracranial arteriovenous malformation (AVM). She underwent bilateral ovariectomy with combined spinal-epidural anesthesia. Tracheal intubation was not performed so that severe changes in blood pressure, partial carbon dioxide pressure, and partial pressure of oxygen could be avoided. There were no complications during surgical anesthesia, but the AVM ruptured soon after her being discharged. AVM is errors in the development of the vasculature that, together with the effects of blood flow, may lead to a focal arteriovenous shunt. In some cases, aneurysms may coexist with AVM. It is said that radiosurgery significantly decreases the risk of hemorrhage in patients with AVM, even before there is angiographic evidence of obliteration. But it should be kept in mind that anesthetic management must be performed carefully.
authors.affiliation: Department of Anesthesiology, Nikko Memorial Hospital, Muroran 051-8501.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kimura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kamada
authors.forename: Akira
authors.initials: A
authors.lastname: Kimura
authors.forename: Kaori
authors.initials: K
authors.lastname: Sato
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D002543:Cerebral Hemorrhage; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000150:complications / Q000601:surgery*; D010052:Ovariectomy; D011183:Postoperative Complications; D016634:Radiosurgery