Spontaneous acute subdural hematoma and intracerebral hemorrhage in a patient with thrombotic microangiopathy during pregnancy.

Abstract

Preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low-platelet count), and acute fatty liver of pregnancy are the main causes of thrombotic microangiopathy and evere liver dysfunction during pregnancy and represent different manifestations of the same pathological continuum. The case of a 35-week pregnant woman who was admitted to an intensive care unit immediately after a Cesarean section due to fetal death and the presence of nausea, vomiting, and jaundice is reported. Postpartum preeclampsia and acute fatty liver of pregnancy were diagnosed. The patient developed an acute subdural hematoma and an intracerebral hemorrhage, which were subjected to neurosurgical treatment. The patient died from refractory hemolytic anemia and spontaneous bleeding of multiple organs. Preeclampsia HELLP syndrome, and acute fatty liver of pregnancy might overlap and be associated with potentially fatal complications, including intracranial hemorrhage, as in the present case. Early detection and diagnosis are crucial to ensure management and treatment success.

• Authors: Sâmia Yasin Wayhs, Joise Wottrich, Douglas Prestes Uggeri, Fernando Suparregui Dias
• Journal: Revista Brasileira de terapia intensiva (Rev Bras Ter Intensiva) 2013 Apr-Jun Vol. 25 Issue 2 Pg. 175-80 ISSN: 1982-4335 [Electronic] Brazil
• PMID: 23917984 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Cerebral Hemorrhage (etiology, physiopathology, surgery)
• Cesarean Section
• Fatty Liver (complications, physiopathology)
• Female
• Fetal Death
• HELLP Syndrome (physiopathology)
• Hematoma, Subdural, Acute (etiology, physiopathology, surgery)
• Humans
• Intensive Care Units
• Pre-Eclampsia (physiopathology)
• Pregnancy
• Pregnancy Complications, Hematologic (physiopathology)
• Thrombotic Microangiopathies (etiology, physiopathology)