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Re: Subarachnoid hemorrhage after deliveryFrom: Geff klein (gklein@bcm.tmc.edu)Fri Dec 8 09:21:37 1995
>We have a 32 yr G2P1 who was sectioned for a mild pre-eclampsia and >twins 6 days ago. On the second day after delivery we had difficulty >in controling her bloodpressure and she complained of severe >headache, initially thought to be of high doses nifedipine. She >developed neck stiffness and a CT scan of the brain was done without >any significant pathology. There was blood on the LP. An Angiogram of >the brain show bloodvessels that are dilated with segments of >narrowing. Our neurosurgeons think of a vasculitis. >Does anyone have any experience with this type of complication? Back in September we had a similar case at BTGH.. The patient was a primigravida hospitalized at 28 weeks gestation with mild Pre-eclampsia. She was placed on bedrest. About a week later at night she developed a severe headache. The next morning, she had altered mental status and developed a third nerve palsy. CT scan of the head demonstrated a large subDURAL hematoma with subfalcine herniation. No seizures or head trauma were reported during or before hospitalization. An emergency craniotomy and evacuation was performed, however, she expired 2 days later from malignant cerebral edema.. Humbling case..
-- Geff Klein, MD gklein@bcm.tmc.edu Baylor College of Medicine Dept of OB-Gyn
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