'Miracle baby': an outcome of multidisciplinary approach to neurotrauma in pregnancy.
Traumatic brain injury (TBI) warranting neurosurgical intervention in the pregnant population is a rarity. We describe a case of a 27-year-old woman who at 13 weeks of gestation presented with multiple traumas having been involved in a near fatal road traffic accident. Glasgow Coma Scale was 6/15. CT brain showed extensive haemorrhagic contusions, diffuse brain swelling and multiple skull and facial fractures. Decompressive craniectomy was performed to control her intracranial pressure during her management in the intensive care. A viable intrauterine pregnancy was confirmed and progressed as maternal stabilisation and rehabilitation continued. At 35+3 weeks a 2770 g male child was delivered via emergency caesarean section after spontaneous onset of labour. The child had no detectable abnormalities and is clinically well. Eight months post-TBI the patient continues to make gradual improvements but is left with severe cognitive impairment and currently undergoing rehabilitation. A multidisciplinary approach was adopted in the management of this patient.
Department of Neurosurgery, Cork University Hospital, Cork, Republic of Ireland.
Grace
G
Neville
Chandrasekaran
C
Kaliaperumal
George
G
Kaar
D000063:Accidents, Traffic; D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D002585:Cesarean Section; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D003399:Craniotomy; D003422:Critical Care / Q000379:methods*; D019299:Decompression, Surgical; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010348:Patient Care Team; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome