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Current Obstetrics and Gynecology Reports

Erschienen in:

24.01.2023 | REVIEW

Neuraxial Techniques in Obstetric Patients with Intracranial Lesions

verfasst von: Kathryn J. Clark, Anthony Chau

Erschienen in: Current Obstetrics and Gynecology Reports | Ausgabe 1/2023

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Abstract

Purpose of Review

A pregnant woman with intracranial pathology can pose unique considerations and challenges on the specific mode of delivery and anesthetic choice. This review aims to summarize the current understanding and data on neuraxial techniques in obstetric patients with intracranial lesions.

Recent Findings

In a majority of cases, neuraxial techniques can be performed safely in obstetric patients with intracranial pathology; however, high-quality data are lacking to support a formulaic approach so decisions should be individualized. Neuraxial techniques should be avoided in those with imaging evidence of significant mass effect causing midline or downward shift of brain tissue, or obstruction to cerebrospinal fluid flow at or above the foramen magnum.

Summary

Any patients with new or worsening neurologic symptoms should be evaluated for raised intracranial pressure. Neuroradiological and neurosurgical consultations are particularly valuable in the decision-making process regarding the mode of delivery and anesthetic technique. In addition to the individual clinical features of each case, the final decision should always take into consideration the patient’s motivation, risk tolerance, and personal preference.

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Titel: Neuraxial Techniques in Obstetric Patients with Intracranial Lesions
verfasst von: Kathryn J. Clark
Anthony Chau
Publikationsdatum: 24.01.2023
Verlag: Springer US
Erschienen in: Current Obstetrics and Gynecology Reports / Ausgabe 1/2023
Elektronische ISSN: 2161-3303
DOI: https://doi.org/10.1007/s13669-023-00345-y

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