To present a staged 'damage control' strategy for managing ruptured arteriovenous malformation (AVM) during pregnancy, focusing on maternal resuscitation and fetal preservation, while clarifying the term 'damage control' for broader understanding.
Key Findings:
Emergency decompression stabilized the patient and allowed for a successful term delivery, highlighting the effectiveness of the staged approach.
The patient achieved full neurological recovery with a modified Rankin Scale score of 0.
The infant remained healthy throughout the pregnancy.
Interpretation:
The staged approach effectively separated acute decompression from vascular treatment, facilitating maternal recovery while preserving fetal viability.
Limitations:
The strategy remains controversial and is not widely detailed in existing literature, and the implications of the family declining further diagnostic interventions should be discussed.
Conclusion:
In cases of ruptured AVM during pregnancy complicated by herniation, a staged management approach can optimize outcomes for both mother and child, emphasizing its importance in the context of existing literature.
Aviva Abosch, M.D., Ph.D., a neurosurgeon at Baptist Health Miami Neuroscience Institute, part of Baptist Health Brain and Spine Care, was installed as the Esernia Endowed Chair in Surgical Treatment of Adult Epilepsy and Movement Disorders.
