カコガワ　ジユン   水主川　純    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Antepartum intracranial hemorrhage due to unrecognized unilateral moyamoya disease: a case report.
掲載誌名	正式名：Archives of gynecology and obstetrics 略　 称：Arch Gynecol Obstet ISSNコード：14320711/09320067
掲載区分	国外
巻・号・頁	283 Suppl 1,pp.19-22
著者・共著者	Kakogawa Jun, Sadatsuki Miyuki, Masuya Norio, Gomibuchi Hideto, Ohno Hiroyasu, Hara Tetsuo, Oda Hiroko, Kimura Akio, Minoura Shigeki
担当区分	筆頭著者,責任著者
発行年月	2011/03
概要	PURPOSE:Moyamoya (meaning a "hazy puff of smoke" in Japanese) disease is a rare cerebrovascular occlusive disease. Moyamoya disease may become symptomatic for the first time during pregnancy. We report a case of antepartum intracranial hemorrhage due to unrecognized unilateral moyamoya disease, which was subsequently diagnosed as HELLP syndrome during the postpartum period.STUDY DESIGN:A case report of a 29-year-old Japanese primigravida who was transported to our hospital at 39 weeks of gestation because of sudden loss of consciousness and left hemiplegia. On arrival, her blood pressure was 143/94 mmHg with 1+ proteinuria by dipstick. Brain computed tomography revealed a right putaminal hemorrhage with intraventricular hemorrhage. The patient delivered a neonate by emergency cesarean section, and an intracranial hematoma was subsequently evacuated. Approximately 3 h postoperatively, she was diagnosed with HELLP syndrome and the following were initiated: IV magnesium sulfate, antihypertensive agents, and transfusion of 10 units of platelets. Angiographic findings were consistent with unilateral moyamoya disease.CONCLUSIONS:Moyamoya disease is a rare entity that must be considered in the differential diagnosis of hemorrhagic stroke during pregnancy. It is important to perform careful monitoring and adequate management with cooperation between obstetricians and other specialists when serious complications arise.
DOI	10.1007/s00404-010-1654-3
PMID	20803208