妊産婦脳出血　　妊娠・産褥期に発症した脳出血の３症例

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The incidence of stroke in women increases during pregnancy and puerperium. Although it is rare, stroke, especially intracerebral hemorrhage, during pregnancy and puerperium is significantly associated with mortality and morbidity. We report 3 cases of intracerebral hemorrhage during pregnancy and puerperium in which aneurysms or arteriovenous malformations were not found. In the first case, a 37-year-old woman presented with deteriorated consciousness and weakness because of the hematoma in the right frontal lobe. The computed tomography (CT) and the cerebral angiogram did not show any sources of the bleeding, and the hematoma was removed. In the second case, a 30-year-old woman suffered from severe disturbance of consciousness, and the CT indicated a hematoma in the left hemisphere. We removed the hematoma immediately, and the postoperative magnetic resonance imaging and the cerebral angiogram revealed moyamoya disease. In the final case, a 34-year-old woman suffered from HELLP syndrome, followed by continuous general seizure. The CT showed brain swelling and multiple small hemorrhages in the right hemisphere and the left occipital lobe. A decompressive craniectomy was performed because of brain swelling. In these cases, rapid diagnosis and proper management brought good maternal and neonatal prognosis.
一般社団法人日本脳卒中の外科学会の論文