妊娠後期巨大動靜脈畸形導致顱內出血之病例報告及麻醉處置

Anesthetic Management of Intracranial Hemorrhage from Huge Arteriovenous Malformations in Late Pregnancy-- A Case Report

妊娠期中因動靜脈畸形導致顱內出血是相當罕見，而且會造成母親及胎兒極大的危險，甚至死亡。本病例為一位二十六歲女性，在懷孕三十六週時，發現有巨大的動靜脈畸形導致顱內出血。為了避免顱內壓力持續性升高，我們成功的在全身麻醉下施行剖腹產，文章中我們也回顧眾多相關的文章來討論在腦血管瘤或顱內出血孕婦身上，全身麻醉及區域麻醉上的考量及相關處理。

Intracranial hemorrhage (ICH) from an arteriovenous malformation (AVM) in pregnancy is quite rare and could lead to exceedingly high maternal and fetal morbidity and mortality. We report a 26-year-old woman at 36 weeks' gestation who sustained ICH due to two huge AVMs. For preventing from progressive increased intracranial pressure (IICP), Cesarean section under general anesthesia was performed successfully. Herein, we also discuss the anesthetic management after reviewing the related current literatures.