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Neurologia 2006-Mar

[Pseudo-emesis gravidarum caused by complicated cerebral venous angioma].

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M M Marcos Toledano
J C Portilla Cuenca
L F Porras Estrada
L Gómez Perals

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Resumo

BACKGROUND

Emesis gravidarum is a common pathology rarely requiring hospitalization to control hydroelectrolytic and metabolic alterations. Although it is typical in the first quarter of pregnancy, it can appear in any moment of the gestation. On the other hand, venous angioma (VA) is the most frequent cerebral vascular malformation. In fact, it is a variant of the normal venous drainage of the brain and it is usually an incidental finding. VA is rarely symptomatic, unless associated with cavernous angiomas. Although uncommon, the clinical complications are very varied, bleeding being the most severe one.

METHODS

We describe a 27 weeks pregnant healthy woman, with repetitive vomiting that was classified like emesis gravidarum. The study was enlarged due to the reappearance of vomiting, accompanied by migraine, bradypsychia and confusional state. Neuroradiological studies showed a choroid plexus haematoma from left lateral ventricle to third ventricle, secondary to the existence of a left parietal VA, without demonstration of associated cavernous angioma.

CONCLUSIONS

Although it is rare, a supratentorial VA, without associated cavernous angioma, may lead to intraventricular hemorrhage. Gestation is the only risk factor associated to VA. By itself, it supposes a tendency to develop ischemic and hemorrhagic, arterial and venous vascular complications.

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