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Case report
Cerebral arteriovenous malformations during pregnancy: a management dilemma
  1. Rubina Sohail1,2,
  2. Qasim Bashir3,
  3. Shahlla Kanwal1 and
  4. Maryam Iqbal Ali2
  1. 1Obstetrics & Gynaecology, Services Institute of Medical Sciences, Lahore, Pakistan
  2. 2Obstetrics & Gynaecology, Hameed Latif Hospital, Lahore, Pakistan
  3. 3Neurology, Hameed Latif Hospital, Lahore, Punjab, Pakistan
  1. Correspondence to Professor Rubina Sohail; rubina95{at}gmail.com

Abstract

The rupture of a brain cranial arteriovenous malformation (bAVM) has been associated with pregnancy; however, due to scarcity of data about this rare condition, management still remains a dilemma both for obstetricians and neurophysicians. The management plan is decided after weighing the benefits of bAVM treatment against the risk of bleeding in pregnancy. There is consensus on deciding the treatment of ruptured brain AVM during pregnancy based on neurological and not obstetrical indications. The management is decided using a multidisciplinary approach.

We report the case of a primigravida who presented at 15 weeks of gestation with intracranial haemorrhage secondary to ruptured bAVM, which was managed by glue embolisation. However, she presented again after 9 days in a moribund condition with fever, vomiting and malaise. The family was very concerned about the patient. The multidisciplinary team after evaluation of patient decided for hysterotomy based on the deteriorating maternal condition.

  • hydrocephalus
  • pregnancy
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Footnotes

  • Twitter @rubinasohail@rubinasohail

  • Contributors RS, SK: manuscript writing; MIA, QB: management and manuscript writing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None delcared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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