Epidural Labor Analgesia and Epidural Surgical Anesthesia in a Patient with Idiopathic Intracranial Pressure with Lumbo-PeritonealShunt: A Rare Case Report

Authors

  • Hanaa Lazhar Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Rajae Tachinante Anesthesia and Critical Care Department, Souissi Maternity Hospital, University Hospital Center Ibn Sina, University Mohammed V, Rabat, Morocco Author
  • Aziz Baydada Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Aicha Kharbach Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Aziz Slaoui Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Yasser Lahbabi Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Hicham Ziani Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Nawfal Caidi Anesthesia and Critical Care Department, Souissi Maternity Hospital, University Hospital Center Ibn Sina, University Mohammed V, Rabat, Morocco Author
  • Rajae Tachinante Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author
  • Rajae Tachinante Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco Author

DOI:

https://doi.org/10.47363/JSAR/2023(4)154

Keywords:

Intracranial Hypertension, Lumbo-Peritoneal ShuntSpinal Anesthesia

Abstract

Background: Idiopathic Intracranial Hypertension (IIH) is due to an increased intracranial pressure with no secondary cause of intracranial hypertension and normal Cerebrospinal fluid (CSF) composition. IIH’s prevalence is high among obese women of childbearing age and subsequently coincides with pregnancy. Symptoms vary among patients and commonly present headaches
and visual impairment. If untreated, it may steer persistent headaches and lasting visual impairment such as diplopia and scotoma
or even blindness.

Case Report: We hereby present the uncommon case of an epidural anesthesia for cesarean section in a patient with idiopathic intracranial hypertension and Lumbo-peritoneal shunt that presented to our obstetrics department in labor. First, epidural labor anesthesia (ELA) with a catheter placed above the LP shunt scar was the chosen course of action. However, ELA was converted to an epidural surgical anesthesia (ESA) for acute fetal distress secondary to a placental abruption.

Conclusion: IIH usually occurs in pregnant women at any trimester. If undiagnosed or poorly managed, it can lead to drastic complications. As uncommon as it may be, all medical practitioners should be familiar with this pathology even though its diagnostic and treatment are exacting. While the optimal anesthetic management is still controversial, epidural anesthesia proved to be very effective.

Author Biographies

  • Hanaa Lazhar, Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

  • Rajae Tachinante, Anesthesia and Critical Care Department, Souissi Maternity Hospital, University Hospital Center Ibn Sina, University Mohammed V, Rabat, Morocco

    Anesthesia and Critical Care Department, Souissi Maternity Hospital, University Hospital Center Ibn Sina, University Mohammed V, Rabat, Morocco

  • Aziz Baydada, Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

  • Aicha Kharbach, Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco 

  • Aziz Slaoui, Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

  • Yasser Lahbabi, Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco 

  • Hicham Ziani, Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

  • Nawfal Caidi , Anesthesia and Critical Care Department, Souissi Maternity Hospital, University Hospital Center Ibn Sina, University Mohammed V, Rabat, Morocco

    Anesthesia and Critical Care Department, Souissi Maternity Hospital, University Hospital Center Ibn Sina, University Mohammed V, Rabat, Morocco

  • Rajae Tachinante, Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco 

  • Rajae Tachinante, Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

    Gynaecology-Obstetrics and Endocrinology Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco

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Published

2023-04-21

Issue

Vol. 4 No. 2 (2023): Volume 4 Issue 2

Section

Articles