Two patients with subarachnoid hemorrhage in pregnancy

Yıl 2013, Cilt: 18 Sayı: 2, 76 - 80, 03.07.2013

Hayriye Gonullu Sevdegul Karadas Mehmet Resit Oncu Mehmet Tasdemir

Öz

Abstract. It has been reported thatheadache in 50-60% of subarachnoid hemorrhage cases has an abrupt onset and issevere with the cause in the 75-80% of events being intracranial aneurysmrupture. This condition, which is also known as sentinel headache andparticularly observed days before the rupture of an aneurysm, is of greatimportance to clinicians. Subarachnoid hemorrhage is rarely seen in pregnancy;on the other hand, it has a high mortality rate for both mother and fetus. Thispaper presents the case studies of two pregnant women who were admitted to thehospital with a sentinel headache, abrupt-onset and variable headachecomplaints, they were consequently diagnosed with subarachnoid hemorrhage. Key words: Subarachnoid hemorrhage, pregnancy, sentinel headache

Anahtar Kelimeler

Subarachnoid hemorrhage, pregnancy, sentinel headache

Kaynakça

• De Luca GC, Bartleson JD. When and how to investigate the patient with headache. Semin Neurol 2010; 30: 131-144.
• Contag SA, Mertz HL, Bushnell CD. Migraine during pregnancy: is it more than a headache? Nat Rev Neurol 2009; 5: 449-456.
• Menon R, Bushnell CD. Headache and pregnancy.Neurologist 2008; 14: 108-119.
• Özücelık DN, Kunt MM, Karaca MA, Çobanoğlu M. Intraserebral Hemorrage During Pregnancy: Case Report. Journal of Academic Emergency Medicine Case Reports 2010; 2: 40-43.
• Kabak S, Aygün D, İyigün Ö, Narğis C. The importance of sentinel headache in patients with intracranial aneurism. Turkısh Journal of Emergency Medicine 2005; 5: 199-201.
• Darbhamulla SV, Reddy R. Subarachnoid hemorrhage in pregnancy. J Obstet Gynaecol 2007; 27: 80-81.
• Witlin AG, Friedman SA, Egerman RS, Frangieh AY, Sibai BM. Cerebrovascular disorders complicating pregnancy-Beyond eclampsia. Am J Obstet Gynecol 1997; 176: 1139-1148.
• Bateman BT, Schumacher HC, Bushnell CD, et al. Intracerebral hemorrhage in pregnancy frequency, risk factors, and outcome. Neurology 2006; 67: 4244
• Yılmaz DM. Spontan Subaraknoid Kanama ve Sonrası Gelişen Vazospazm ve Geç İskemik Defisitte Serum ve Beyin Omurilik Sıvısında Sitokin Düzeylerinin Araştırılması. Uzmanlık tezi Adana 200 Tate J, Bushnell C. Pregnancy and stroke risk in women. Womens Health (Lond Engl) 2011; 7: 3633
• Sharshar T, Lamy C, Mas JL. Incidence and causes of strokes associated with pregnancy and puerperium. A study in public hospitals of Ile de France. Stroke in Pregnancy Study Group. Stroke 1995; 26: 930-936.
• Denny CJ, Schull MJ. Headache and Facial Pain. In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw-Hill; 2004. pp. 1375-1382.
• Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. New Engl J Med 2000; 342: 29-36.
• Scott PA. Timmerman CA. Stroke, Transıent Ischemıc Attack, And Other Central Focal Condıtıons In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw-Hill; 2004. pp.1382-1390.
• Jeng JS, Tang SC, Yip PK. Incidence and etiologies of stroke during pregnancy and puerperium as evidenced in Taiwanase Women. Cerebrovasc Dis 2004; 18: 290-295.
• Simolke GA, Cox SM, Cunningham FG. Cerebrovascular accidents complicating pregnancy and the puerperium. Obstet Gynecol 1991; 78: 37-42.
• Moussouttas M, Abubakr A, Grewal RP, Papamitsakis N. Eclamptic subarachnoid haemorrhage without hypertension. J Clin Neurosci 2006; 13: 474-476.
• Jung SY, Bae HJ, Park BJ, Yoon BW. Acute Brain Bleeding Analysis Study Group.Parity and risk of hemorrhagic strokes.Neurology 2010; 74: 142414
• Kanani N, Goldszmidt E. Postpartum rupture of an intracranial aneurysm. Obstet Gynecol 2007; 109: 572-5
• Matsubara S, Kuwata T, Ohkawara Y, Makino S. Headache in late pregnancy: a symptom for VogtKoyanagi-Harada disease. Arch Gynecol Obstet 2011; 283: 1423-1425.
• Gorson R. O. report No. 054-Medical radiation exposure of pregnant and potentially pregnant women (National Council on radiation Protection and Measurements), Bethesda, MD, 1977.
• Mosiewicz A, Jakiel G, Janusz W, Markiewicz P. Treatment of intracranial aneurysms during pregnancy. Ginekol Pol 2001; 72: 86-92.
• Greenberg MS. Neurosurgery of Handbook. SAH and Aneurysms (3 rd ed). Florida: Greenberg Graphics, 1994.