DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191358

Spontaneous subdural hematoma in a multigravida with chronic kidney disease and superadded pre-eclampsia detected by MRI: a case report

Preeti Yadav, Arindam Mukherjee, Rakesh Kumar

Abstract


Chronic kidney disease and pre-eclampsia are both known individual culprits for significant morbidity and mortality of mother and child worldwide. Non traumatic spontaneous subdural hematoma in pregnancy is a rare scenario, however stage 5 chronic kidney disease with superadded pre-eclampsia can be contributory factor for spontaneous extra axial bleed. Our patient was 25-year-old with history of end stage renal disease and chronic hypertension admitted with superadded pre-eclampsia. She had 1 living issue and 2 stillbirths. There was sudden deterioration of mental status as well as motor performance, the patient turned stupurous and was not following verbal commands. Patient was sent for MRI evaluation of brain and diagnosed as right sided subdural hematoma with significant midline shift towards the contralateral side. No intraparenchymal haemorrhage was noted.


Keywords


Chronic kidney disease, Magnetic resonance imaging, Pre-eclampsia, Subdural hematoma

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References


Imdad A, Jabeen A, Bhutta ZA. Role of calcium supplementation during pregnancy in reducing risk of developing gestational hypertensive disorders: a meta-analysis of studies from developing countries. BMC Public Health. 2011;11(3):S18.

Khan KS, Wojdyla D, Say L, G├╝lmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066-74.

Srinivas SK, Edlow AG, Neff PM, Sammel MD, Andrela CM, Elovitz MA. Rethinking IUGR in preeclampsia: dependent or independent of maternal hypertension?. J Perinatol. 2009;29(10):680.

Williams D, Davison J. Chronic kidney disease in pregnancy. BMJ. 2008;336(7637):211-5.

Fobben ES, Grossman RI, Atlas SW, Hackney DB, Goldberg HI, Zimmerman RA, et al. MR characteristics of subdural hematomas and hygromas at 1.5 T. Am J Roentgenol. 1989;153(3):589-95.

Seo DH, Lee KS, Shim JJ, Yoon SM. Multiple episodes of haemorrhage identified in MRI of chronic subdural hematomas. Korean J Neurotrauma. 2014;10(1):22-5.

Lee KS, Shim JJ, Yoon SM, Doh JW, Yun IG, Bae HG. Acute-on-chronic subdural hematoma: not uncommon events. J Korean Neurosurgical Soc. 2011;50(6):512.

Yadav P, Verma A, Chatterjee A, Srivastava D, Riaz MR, Kannaujia A. Spontaneous extradural hemorrhage in a patient with chronic kidney disease: a case report and review of literature. World Neurosurg. 2016;90:707-e13.

Shahlaie K, Fox A, Butani L, Boggan JE. Spontaneous epidural hemorrhage in chronic renal failure. Pediat Nephrol. 2004;19(10):1168-72.

Lin LT, Tsui KH, Cheng JT, Cheng JS, Huang WC, Liou WS, et al. Increased risk of intracranial haemorrhage in patients with pregnancy-induced Hypertension. Medicine (Baltimore). 2016;95(20):e3732