title: [Anesthesia in pregnant patient with intracranial hypertension due to tuberculous meningitis: case report.].
abstract: OBJECTIVE
  It is a well-established fact today that the technique of choice for elective cesarean delivery is regional anesthesia. However, in patients with intracranial hypertension and central nervous system infection, this technique should be avoided. This paper aimed at reporting the anesthetic management of a pregnant patient with intracranial hypertension due to tuberculous meningitis submitted to elective cesarean delivery.
  
  
  METHODS
  Caucasian patient, 32 years old, 1.62 m height and 60 kg weight, in the 36th week of gestational age admitted to the obstetrics unit to have her pregnancy interrupted by cesarean delivery because she had become quadriparetic with hydrocephalus due to tuberculous meningitis. The chosen technique was general anesthesia with rapid sequence induction and Sellick maneuver for intubation. Drugs were intravenous thiopental (250 mg), rocuronium (50 mg), fentanil (100 microg) and lidocaine (60 mg). Anesthetic induction was very smooth, with minor changes in vital signs. Anesthesia was maintained with isoflurane until the beginning of incision suture. The baby was delivered quickly and received an Apgar score of 8 e 9 in the 1st and 5th minutes, respectively, and patient woke up as soon as the procedure ended without any additional neurological deficits.
  
  
  CONCLUSIONS
  General anesthesia is still the best anesthetic technique for Cesarean delivery in patients with intracranial hypertension. Choice of drugs should include those with short half-life and with minor effects on intracranial pressure and on the newborn.
authors.affiliation: Serviço de Anestesia e Analgesia Serviço de Anestesia e Analgesia, Porto Alegre.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Breitenbach
authors.forename: David Henry
authors.initials: DH
authors.lastname: Wilson