Asian Journal of Case Reports in Medicine and Health

Intracranial Hemorrhage in Pregnancy: Case Report and Review of Literature

Ayoub Ettaje *

Department of Obstetrics, Intensive Care Unit and Anesthesia, Maternity Souissi Hospital, University Mohamed V, Rabat, Morocco.

Abdelali Kallali

Department of Obstetrics and Gynaecology, Faculty of Medicine, Maternity Souissi Hospital, Rabat, Morocco.

Hicham Ziani

Department of Obstetrics, Intensive Care Unit and Anesthesia, Maternity Souissi Hospital, University Mohamed V, Rabat, Morocco.

Abdelaziz Baydada

Department of Obstetrics and Gynaecology, Faculty of Medicine, Maternity Souissi Hospital, Rabat, Morocco.

Anas Saoud Tazi

Department of Obstetrics, Intensive Care Unit and Anesthesia, Maternity Souissi Hospital, University Mohamed V, Rabat, Morocco.

*Author to whom correspondence should be addressed.

---

Abstract

Intracranial hemorrhage during pregnancy is a rare but life-threatening event during pregnancy. There is a major risk of maternal and fetal death and morbidity. The risk of hemorrhage increases during the third trimester and is greatest during labor and postpartum.

We report a dramatic case of a 33-year-old primigravida 38 weeks by gestation complicated by eclampsia and intracranial hemorrhage with cerebral mass effect. She was managed by an emergency cesarean section and craniotomy but without desirable results, we were not able tosave the patient, she died on day 2. The publication of such cases could provide another insight into pre-eclampsia and its life-threatening complications.

Keywords: Intracranial hemorrhage, eclampsia, intraparenchymal hemorrhage

---

---

---

References

Razmara A, Bakhadirov K, Batra A, Feske SK. Cerebrovascular complications of pregnancy and the postpartum period. Curr Cardiol Rep. 2014;16(10):532

Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, Howard VJ, Lichtman JH, Lisabeth LD, Piña IL, Reeves MJ, Rexrode KM, Saposnik G, Singh V, Towfighi A, Vaccarino V, Walters MR; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council for High Blood Pressure Research.Stroke. 2014;45(5):1545-88.

DOI:10.1161/01.str.0000442009.06663.48. Epub 2014 Feb 6.

Jun C. Takahashi, Koji Iihara, Akira Ishii, Eiju Watanabe, Tomoaki Ikeda. Susumu Miyamoto, MD, PhD. Pregnancy-associated Intracranial Hemorrhage: Results of a Survey of Neurosurgical Institutes across Japan.journal of troke and cerebrovascular disease. 2014;23(2):E65-E71. Available:https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.08.017

Meeks JR, Bambhroliya AB, Alex KM, Sheth SA, Savitz SI, Miller EC, McCullough LD, Vahidy FS. Association of primary intracerebral hemorrhage with pregnancy and the postpartum period. JAMA Network Open. 2020;3(4):e202769. DOI:10.1001/jamanetworkopen.2020.2769

Zunker P, Happe S. Georgiadis AL, Louwen F, Georgiadis D, Ringelstein EB, Holgreve W. Maternal cerebral hemodynamics in pregnancy-related hypertension. A prospective transcranial Doppler study. Ultrasound Obstet Gynecol. 2000;16:179 –187.

Marilyn J. Cipolla, Cerebrovascular Function in Pregnancy and Eclampsia, American Heart Association Journals, Hypertension. 2007;50:14–24. Available:https://doi.org/10.1161/HYPERTENSIONAHA.106.079442.

Mas JL, Lamy C. Stroke in pregnancy and the postpartum period. In: Ginsberg MD, Bogousslavsky J, eds. Cerebrovascular Disease: Pathophysiology, Diagnosis and Management. Malden, MA: Blackwell Science. 2004;1684 –1697.

Vn Alebeek ME, de Heus R, Tuladhar AM, de Leeuw FE. Pregnancy and ischemic stroke: a practical guide to management. Curr Opin Neurol. 2018;31(1):44-51

Donaldson JO. The brain in eclampsia. Hypertens Pregnancy. 1994;13:115–133.

Richards AM, Graham DI, Bullock MR. Clinical pathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatr. 1988;51:416–421.

Schwartz RB, Jones KM, Kalina P, Gajakian RL, Mantello MT, Garada B, Holman BL. Hypertensive encephalopathy: findings on CT, MR-imaging, and SPECT-imaging in 14 cases. Am J Radiol. 1992; 159:379–383.