1991 Volume 43 Issue 6 Pages 591-597
We report two cases of intracerebral hemorrhage (ICH) in gravidity, which, although infrequent, is a fatal complication. Both patients were primipara. One showed evidence of small frontal hemorrhage twice, once at 19-weeks gestation and again just postpartum. A mature baby was delivered vaginally by vacuum delivery. The other woman suddenly developed a large parietal hemorrhage at 37 weeks gestation and could not undergo neurosurgery. As conservative treatment, emergency cesarean section was performed because FHR monitor showed fetal distress. In both cases, CT scan and arterioangiography of the hemorrhage revealed a focal lesion thus confirming a diagnosis of “rupture of arteriovenous malformation”. Intracranial vascular disease is exacerbated during pregnancy due to changes in hemodynamics, the hormonal system and coagulatory system. The cerebral bleeding is principally caused by rupture of AVM or aneurysm. Recent developments in obstetrical management and neurosurgery have remarkably improved the prognosis for ICH during pregnancy.
