Impact of pseudotumor cerebri (idiopathic intracranial hypertension) in pregnancy: a case report.
This case report reviews anesthetic management and medical considerations for a pregnant patient with a history of pseudotumor cerebri (PTC). The 24-year-old woman, gravida 2, paragravida 0, spontaneous abortion 1, was in active labor at an estimated 38 weeks' gestation and had been given a diagnosis of PTC 4 years earlier. This patient first experienced global headaches and blurred vision at age 20 years. At the time of onset of her headache symptoms, she underwent a full diagnostic workup and detailed neurologic examination, including magnetic resonance imaging (MRI) of the brain and a lumbar puncture. The MRI was normal. Her lumbar puncture showed elevated cerebral spinal fluid (CSF) pressures and normal CSF composition. The patient's initial symptoms of headache and blurred vision were managed with medication and serial lumbar punctures. The patient was free of PTC symptoms on admission for labor. A lumbar epidural was placed for labor analgesia. The patient delivered a healthy infant after approximately 10.5 hours of patient-controlled epidural analgesia.
Worrell
Jeff
J
CRNA group, Alaska, USA.
Lane
Susan
S
D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods* / Q000451:nursing; D016362:Analgesia, Obstetrical / Q000379:methods* / Q000451:nursing; D016058:Analgesia, Patient-Controlled / Q000379:methods* / Q000451:nursing; D003937:Diagnosis, Differential; D004172:Diplopia / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D033221:Jehovah's Witnesses; D048949:Labor Pain / Q000150:complications / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008487:Medical History Taking; D008991:Monitoring, Physiologic; D009719:Nurse Anesthetists; D009730:Nursing Assessment; D009767:Obesity, Morbid / Q000150:complications; D010808:Physical Examination; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy; D011559:Pseudotumor Cerebri / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D013129:Spinal Puncture; D058609:Visual Field Tests