전자간이 있던 산모에서 분만 5일후 발생한 뇌실질내 출혈 - 증례보고 -

Intracranial Hemorrhage Developed from Patient Who Had Been Preeclampsia at Five Days Postpartum - A Case Report -

  • 이창우 (을지대학교 의과대학 신경외과학교실) ;
  • 김용석 (을지대학교 의과대학 신경외과학교실) ;
  • 박문선 (을지대학교 의과대학 신경외과학교실) ;
  • 하호균 (을지대학교 의과대학 신경외과학교실) ;
  • 이종선 (을지대학교 의과대학 신경외과학교실) ;
  • 정호 (을지대학교 의과대학 신경외과학교실) ;
  • 김주승 (을지대학교 의과대학 신경외과학교실)
  • Lee, Chang-Woo (Department of Neurosurgery, Eulji University School of Medicine) ;
  • Kim, Yong-Seog (Department of Neurosurgery, Eulji University School of Medicine) ;
  • Park, Moon-Sun (Department of Neurosurgery, Eulji University School of Medicine) ;
  • Ha, Ho-Guyn (Department of Neurosurgery, Eulji University School of Medicine) ;
  • Lee, Jong-Sun (Department of Neurosurgery, Eulji University School of Medicine) ;
  • Jung, Ho (Department of Neurosurgery, Eulji University School of Medicine) ;
  • Kim, Joo-Seung (Department of Neurosurgery, Eulji University School of Medicine)
  • 투고 : 2000.04.25
  • 심사 : 2000.09.20
  • 발행 : 2001.03.28

초록

Intracranial hemorrhage due to preeclampsia in the postpartum woman is rarely documented. Generally, the incidence of stroke is increased during pregnancy and early postpartum. Preeclampsia is considered a main cause of both nonhemorrhagic and hemorrhagic stroke. We present a 32-year-old woman who had intracranial hemorrhage at 5 days postpartum. At admission, her consciousness was semicomatose with elevated blood pressure. Computerized tomography revealed intracranial hemorrhage on right frontal lobe. Additional angiography did not reveal abnormal vascular lesion. Emergency craniectomy with hematoma removal was done. However, the patient showed no recovery and died 2 weeks later. We conclude that postpartum care of preeclampsia is important to prevent intraparenchymal hemorrhage. Relative high risk of stroke during the postpartum period suggests a causal roles for the large decrease in blood volume or the rapid changes in hormonal status that follow a live birth or stillbirth, perhaps by means of hemodynamics, coagulative, or vessel wall changes.

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