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CASE REPORT
Year : 2007  |  Volume : 51  |  Issue : 3  |  Page : 244-246

Emergency caesarean section in a patient with intracerebral tuberculoma


1 M.D. Senior Resident, Departments of Anaesthesiology and Intensive care and Neuroanaesthesiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
2 M.D. Assistant Professor, Departments of Anaesthesiology and Intensive care and Neuroanaesthesiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India

Correspondence Address:
Hemanshu Prabhakar
Assistant Professor, Department of Neuroanaesthesiology, Neurosciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029
India
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Source of Support: None, Conflict of Interest: None


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The incidence of tuberculosis in pregnancy ranges between 1-2% amongst hospital deliveries in the trop­ics. Tuberculosis of central nervous system accounts for about 5% of extra pulmonary cases and manifests as meningitis or uncommonly as tuberculoma. The management of intracerebral tuberculoma diagnosed during pregnancy should be same as that in non-pregnant subjects with antituberculous treatment. Emergency caesar­ean section in a patient with intracerebral tuberculoma poses unique challenges to the anaesthesiologist. There are no published reports on anaesthetic management of pregnancy with tuberculoma. We report the case of a woman with intracerebral tuberculoma presenting for emergency caesarean section. The anaesthetic goals in this patient were combined to that of principles of obstetrical anaesthesia to ensure a favourable maternal and fetal outcome. The anaesthetic technique chosen should prevent aspiration, avoid fluctuations in intracranial pressure, maintain stable haemodynamics, provide a sufficient depth of anaesthesia and good postoperative analgesia. We believe that general anaesthesia is the safest approach in such patients. We suggest general anaesthesia to be preferred over regional anaesthesia technique.


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