A Patient with Subarachnoid Hemorrhage Related to a Ruptured Aneurysm in Week 8 of Pregnancy: Usefulness of Coil Embolization of Intracranial Aneurysms as a Treatment Option before Delivery

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Object: We report a case of endovascular surgery for subarachnoid hemorrhage (SAH) that developed in early pregnancy.

Case Presentations: An 8-week pregnant 35-year-old female was admitted to our hospital with severe headache and loss of consciousness. Cephalic computed tomography (CT) revealed SAH (Hunt and Hess grade II). Digital subtraction angiography (DSA) demonstrated a 2.7 mm aneurysm at the right internal carotid artery-posterior communicating artery (IC-PC) bifurcation. We prioritized maternal treatment. Cerebral aneurysm coil embolization was performed on the 1st day under general anesthesia. During the operation, we tried to avoid irradiating the fetus by limiting the irradiation range and time. She was discharged on the 36th day of illness and gave birth to a 2532-g baby at 36 weeks of gestation.

Conclusion: If SAH develops in early pregnancy, it is necessary to prioritize maternal treatment. Endovascular surgery should be considered as a treatment option.