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Revista Cubana de Medicina Militar

Print version ISSN 0138-6557On-line version ISSN 1561-3046

Abstract

PRINCE LOPEZ, José Antonio et al. Conduct to be followed in the cerebrovascular malformations in pregnancy and puerperium. Rev Cub Med Mil [online]. 2008, vol.37, n.3. ISSN 0138-6557.

A review of the present concepts for the diagnosis and treatment of pregnant women who are diagnosed an intracranial vascular malformation, with emphasis on the repercussion that it or surgery may have on the fetus and the mother, was made. The conduct to be followed before an arteriovenous malformation or an aneurysm during gestation or puerperium is still a controversial topic in neurosurgery. The intracranial hemorrhages (subarachnoid and/or intraparenchymatous) occuring during pregnancy and puerperium are rare. Some authors estímate their incidence between 0.002 and 0.005 % of all pregnant women. It is reported that mortality associated with subararachnoid hemorrhages in pregnancy is from 27 to 40 %. They are also considered responsible for 4-12 % of the maternal deaths. It is stated that in the brain aneurysms, the risk at bleeding increases as pregnancy progresses, with a higher possibility of rupture in the third trimestre. The treatment of aneurysms bleeding during gestation is similar to the one applied to those female patients that are not pregnant. The best way to treat a gravid patient with intracranial hemorrhage resulting from an intracranial vascular malformation has not been established yet. The therapeutic decision should be made case by case.

Keywords : Pregnancy; puerperium; arteriovenous malformation; aneurysm; intracranial hemorrhage.

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