Korean J Anesthesiol.  1997 Dec;33(6):1217-1219. 10.4097/kjae.1997.33.6.1217.

Anesthesia for a Patient with Moyamoya Disease presenting for Emergency Cesarean Section: A case report

• Chung CD
• So KY
• Lim KJ
• Moon HK

• KMID: 2299273
• DOI: http://doi.org/10.4097/kjae.1997.33.6.1217

Abstract

Moyamoya disease is a rare, progressive, occlusive cerebrovascular disorder characterized by bilateral stenosis of the intracranial portion of the internal carotid artery. Symptoms including transient ischemic attacks, seizures, intracranial hemorrhage and cerebral infarction, are variable. There are few case reports of moyamoya disease in pregnancy. Since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, cesarean section has been recommended to avoid neurologic complications for pregnant women with moyamoya disease. The optimal anesthetic management for cesarean section in these patients has not been discussed. We report a case of moyamoya disease in a patient presenting for cesarean section at 40 weeks' gestation. Epidural anesthesia was administered using 0.5% bupivacaine and fentanyl. Intraoperative hemodynamic state was stable. The patient has no significant postoperative complications.

Keyword

Anesthesia, epidural; Disease, moyamoya; Pregnancy, cesarean section

MeSH Terms

Anesthesia*
Anesthesia, Epidural
Brain Ischemia
Bupivacaine
Carotid Artery, Internal
Cerebral Infarction
Cerebrovascular Disorders
Cesarean Section*
Constriction, Pathologic
Emergencies*
Female
Fentanyl
Hemodynamics
Humans
Hypertension
Intracranial Hemorrhages
Ischemic Attack, Transient
Moyamoya Disease*
Postoperative Complications
Pregnancy
Pregnant Women
Seizures
Bupivacaine
Fentanyl