ANAESTHETIC APPROACH FOR ELECTIVE CAESAREAN SECTION IN A PREGNANT PATIENT WITH MOYAMOYA DISEASE – CASE REPORT

Joshi Aishwarya*, Kumar Shailesh and Kulkarni Prasad

ABSTRACT

Moyamoya disease (MMD) is defined by vaso-occlusive changes at the internal carotid and cerebral arteries, leading to proliferation of an abnormal vascular network at the base of the brain. The disease is manifested by ischemic, hemorrhagic strokes or transient ischemic attacks. Pregnant and puerperal MMD patients may be at a higher risk of developing new strokes as well as during the peripartum period. Since hyperventilation-induced cerebral ischemia and hypertension are provoked by active labor, elective cesarean section has been recommended to avoid neurologic complications for pregnant women with moyamoya disease. We report the successful use of epidural anesthesia in the management of a term parturient with moyamoya disease undergoing cesarean section.

Keywords: MMD(Moya moya disease), ICA(Internal carotid artery), MCA (Middle carotid artery), PCOM (Posterior communicating artery), COW(Circle of willis), DVT( deep vein thrombosis).