Transcranial Doppler blood flow measurement during cesarean section in two patients with cerebral vascular disease

R. M. Smiley, D. M. Ridley, A. Hartmann, C. F. Ciliberto, L. Baxi

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

We present two cases of neurovascular disease in pregnancy in which transcranial Doppler was used to assess the status of the cerebral circulation during cesarean section under regional anesthesia. One woman had been found to have moyamoya disease, following a series of transient ischemic attacks during her first pregnancy, which ended in spontaneous abortion. On this occasion she was delivered by cesarean section under slowly-induced epidural anesthesia, using ephedrine to maintain the blood pressure, and transcranial Doppler revealed no change in signal in her left middle cerebral artery. Both mother and baby had an uneventful post natal course. The second case involved a primiparous woman with a large arteriovenous malformation that had been detected following generalized seizures, which were treated with valproic acid. Her cesarean section was conducted under spinal anesthesia, and her blood pressure maintained with ephedrine. Again trancranial Doppler revealed no change in signal in her middle cerebral artery during the procedure. We believe this is a potentially useful technique to monitor the cerebral circulation intraoperatively in the presence of cerebrovascular disease.

Original languageEnglish (US)
Pages (from-to)211-215
Number of pages5
JournalInternational Journal of Obstetric Anesthesia
Volume11
Issue number3
DOIs
StatePublished - Jan 1 2002

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Anesthesiology and Pain Medicine

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