Pregnancy and cerebral aneurysms

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Pregnancy and cerebral aneurysms. Pregnancy increases the risk of aneurysm development and rupture. Fully referenced neurology checklist.

Pathogenesis of aneurysms in pregnancy

  • Pregnancy increases the risk of aneurysm development and rupture
  • This is due to the haemodynamic changes in pregnancy
  • The high plasma volume in pregnancy may delay the onset of symptoms of aneurysm rupture
  • Features of rupture may be wrongly attributed to eclampsia
  • Rupture may compromise placental blood flow and cause foetal distress

Aneurysm rupture risk in pregnancy

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Features predicting high risk of aneurysm rupture

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Management of pregnancy with an aneurysm

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Management of aneurysms in pregnancy

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Outcomes of pregnancies with aneurysms

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Predictors of maternal mortality

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References

  1. Barbarite E, Hussain S, Dellarole A, Elhammady MS, Peterson E. The management of intracranial aneurysms during pregnancy: a systematic review. Turk Neurosurg 2016; 26:465-474.
  2. Pankaja S, Choudhary V, Rashid M. Ruptured intracranial aneurysm in pregnancy: a case report. BMJ Case Rep 2009; pii: bcr07.2008.0437. 
  3. Roman H, Descargues G, Lopes M, et al. Subarachnoid hemorrhage due to cerebral aneurysmal rupture during pregnancy. Acta Obstet Gynecol Scand 2004; 83:330-334.
  4. Tanaka H, Katsuragi S, Tanaka K, et al. Impact of pregnancy on the size of small cerebral aneurysm. J Matern Fetal Neonatal Med 2017; 30:2759-2762. 
  5. Davie CA, O'Brien P. Stroke and pregnancy. JNNP 2008; 79:240-245. 
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