Hemorrhagic stroke following elective cesarean delivery.
We present a case of hemorrhagic stroke after cesarean delivery under combined spinal-epidural anesthesia in an 35-year-old Hispanic patient treated with anticoagulants for protein C deficiency. She required vasopressor therapy for intraoperative hypotension and developed severe headache immediately after administration. To our knowledge, this is the first case of stroke occurring in a pregnant woman following vasopressor therapy for spinal anesthesia-induced hypotension. Although the exact cause of her hemorrhagic stroke is uncertain, the hypertensive response that may have led to the hemorrhagic stroke occurred following administration of commonly used doses of vasopressor agents. We discuss the possible causes of stroke.
Department of Anesthesiology, Jackson Memorial Medical Center, University of Miami Miller School of Medicine, Miami, Florida 33136, USA. jranasinghe@med.miami.edu
J S
JS
Ranasinghe
S
S
Kafi
J
J
Oppenheimer
D J
DJ
Birnbach
D000328:Adult; D000765:Anesthesia, Conduction; D002543:Cerebral Hemorrhage / Q000150:complications*; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D004809:Ephedrine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007022:Hypotension / Q000188:drug therapy / Q000209:etiology; D010656:Phenylephrine / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D020151:Protein C Deficiency / Q000150:complications; D020521:Stroke / Q000209:etiology*; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects*
D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D004809:Ephedrine