Sunday, July 25, 2010

Pregnancy Headache

Warning: Sad case for any pregnant readers.

A 23 year old, 16 weeks pregnant female came in with headache, vision changes, and right sided weakness. With pregnant females, we are always very conservative. But in this case, we had to do a cat scan. She was obviously having a big brain bleed.


Before her presentation with the bleed, she was completely healthy. We think she had a AVM that had always been asymptomatic. To date, she and the baby are still alive.

Weird thing is we had the same case in our ER 1 week ago, except the patient was 33 years old and 26 weeks pregnant. She wasn't as lucky.

-ER Doc

15 comments:

binkRN said...

We had one of these in our ER about 4 years ago. Very sad, and a few of us had a hard time with it for awhile. Especially when a couple of us got pregnant.
She died, her child was saved. It was such a helpless feeling to see her deteriorate before my eyes and know there was nothing I could do except save prolong her life enough so that the baby could be saved.
I hope I never see this again. Yet, I know that is asking for a miracle.

tracy said...

Just. So. Very. Very. Sad, i am so sorry,

SerenityNowHospital said...

pregnancy head bleed and inhaling a condom....and only 2 comments? where are my peeps. the only way i guage people are still reading this things is by the comments we get. so please comment every once and awhile so we keep this thing going.

er doc

Anonymous said...

Not much to say but that it is sad that this woman has to go through this. Is she still alive? Is there a chance of her surviving? Is she married? If so, my heart goes out to her husband and also to her family.

serenitynowhospital said...

still alive, should live with major deficits, yes married. first time pregnant

er doc

Anonymous said...

What about the baby? will it survive or will it cause more problems for the mother? How early can a baby be born and live without any major complications?

tracy said...

Whenever i make a comment, on a "controversial" topic, i just make trouble... :(

Usually a "psych" entry.....

SerenityNowHospital said...

we love controversial comments. keeps people reading

arzt4empfaenger said...

Ouch, this is tragic on several levels. Not something I want to experience myself, neither as husband nor sibling or other parent.

SerenityNowHospital said...

if the mom stays stable and can take in enough calories to let the baby grown, and she doesnt have any other complications, the baby could be ok.

in this country, we electively deliver babies really early in cases like this (still to early in this case), hence our higher neonatal death rates. but generally, the longer you can carry the better.

er doc

ERP said...

Ouch. I had one of them about a year ago - she did pretty well luckily.

Anonymous said...

What's the cause of this?

Anonymous said...

Our ED would have shipped this girl right up to L & D, regardless of the gestational age. Because they are always "concerned for the baby".

Anonymous said...

That's a HUGE bleed! What was she like post op?

anonymousrn said...

We had a similar case in our ICU a month or so ago. She was in her early 20's. Baby was around 25 weeks. Community hospital thought the headache and decreased LOC was from pre-eclampsia, but her condition didn't improve after emergency c-section. CT scan showed a large bleed. Little guy didn't make it. Am not sure what mom's recovery looks like.