{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:43:28Z","timestamp":1777045408147,"version":"3.51.4"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":1658,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:p>De novo obstructive hydrocephalus is a rare event during pregnancy. There are only case reports presented in literature. We aimed to discuss the pathophysiological basis and management options with an exemplary case presentation and review of the current literature. A 28-year-old G2P1 patient presented to our clinic with headache, vomiting, and deteriorated vision at the 8th week of gestation. She had no history of central nervous system infection or trauma. A brain magnetic resonance imaging was obtained. There was hydrocephalus due to cerebral aqueduct stenosis (Evan's index of 58%). She was managed conservatively with bed rest and diuretics; however, she got no relief. A ventriculoperitoneal shunt was inserted at the 13th week of gestation. At the 38th week, she had cesarean section (C\/S) due to previous history of C\/S in the first pregnancy and present cord entanglement of the fetus. C\/S was conducted under epidural anesthesia after conforming she had no increased intra cranial pressure findings. Delivery was uneventful with a healthy newborn. Obstructive hydrocephalus is a very rare complication during pregnancy. Hydrocephalus becomes obvious and necessitates treatment, before the third trimester of pregnancy. Timely diagnosis, especially differentiation from preeclampsia, is a life-saving step. If no complication happens during intervention for hydrocephalus, spontaneous vaginal delivery is a safe way of delivery for both mother's and newborn's well-being. C\/S should be saved for obstetrical indications and can be conducted under epidural anesthesia if intracranial pressure is kept under control. Interdisciplinary approach of neurosurgeons and anesthesiologists is pivotal for delicate care of the patient and the baby.<\/jats:p>","DOI":"10.4103\/1793-5482.181127","type":"journal-article","created":{"date-parts":[[2016,4,25]],"date-time":"2016-04-25T09:01:46Z","timestamp":1461574906000},"page":"123-127","source":"Crossref","is-referenced-by-count":11,"title":["Management of obstructive hydrocephalus in pregnant patient"],"prefix":"10.1055","volume":"13","author":[{"given":"Murat","family":"Eksi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California at San Francisco, San Francisco, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet","family":"\u00d6grenci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Batman State Hospital, Batman"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman","family":"Bat\u00e7\u0131k","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Recep Tayyip Erdogan University, Rize"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orkun","family":"Koban","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Goztepe Medical Park, Istanbul"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"key-10.4103\/1793-5482.181127-1","doi-asserted-by":"crossref","unstructured":"Stagno V, Navarrete EA, Mirone G, Esposito F. Management of hydrocephalus around the world. World Neurosurg 2013;79 (2 Suppl):S23.e17-20.","DOI":"10.1016\/j.wneu.2012.02.004"},{"key":"key-10.4103\/1793-5482.181127-2","doi-asserted-by":"crossref","unstructured":"Oi S. Classification and definition of hydrocephalus-origin, controversy and assignment of the terminology. In: Cinalli G, Sainte-Rose C, Maixner W, editors. Pediatric Hydrocephalus. Italia: Springer-Verlag; 2005. p. 95-112.","DOI":"10.1007\/978-88-470-2121-1_6"},{"key":"key-10.4103\/1793-5482.181127-3","first-page":"562","volume-title":"Obstetric management of pregnant women with extracranial shunts","author":"Monfared","year":"1979","journal-title":"Can Med Assoc J"},{"key":"key-10.4103\/1793-5482.181127-4","first-page":"99","volume-title":"Pregnancy in patients with ventriculoperitoneal shunts: Report of two cases","author":"Howard","year":"1981","journal-title":"Am J Obstet Gynecol"},{"key":"key-10.4103\/1793-5482.181127-5","first-page":"151","volume-title":"Large extra-abdominal cyst as a postpartum complication of peritoneal shunt.Case report","author":"Nugent","year":"1986","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.181127-6","first-page":"827","volume-title":"Pregnancy in patients with cerebrospinal fluid shunts: Report of a series and review of the literature","author":"Wisoff","year":"1991","journal-title":"Neurosurgery"},{"key":"key-10.4103\/1793-5482.181127-7","first-page":"281","volume-title":"Multiple cerebellar haemangioblastomas symptomatic during pregnancy","author":"Naidoo","year":"1998","journal-title":"Br J Neurosurg"},{"key":"key-10.4103\/1793-5482.181127-8","first-page":"816","volume-title":"Neurocysticercosis in pregnancy: A case initially diagnosed as eclampsia","author":"Suarez","year":"1999","journal-title":"Obstet Gynecol"},{"key":"key-10.4103\/1793-5482.181127-9","first-page":"179","volume-title":"Huge acoustic neurinomas presenting in the late stage of pregnancy.Treatment options and review of literature","author":"Beni-Adani","year":"2001","journal-title":"Acta Obstet Gynecol Scand"},{"key":"key-10.4103\/1793-5482.181127-10","first-page":"219","volume-title":"Anesthetic management of a parturient with cerebellopontine-angle meningioma","author":"Bharti","year":"2002","journal-title":"Int J Obstet Anesth"},{"key":"key-10.4103\/1793-5482.181127-11","first-page":"1055","volume-title":"A knot in the catheter \u2013 An unusual cause of ventriculo-peritoneal shunt blockage","author":"Chopra","year":"2004","journal-title":"Acta Neurochir (Wien)"},{"key":"key-10.4103\/1793-5482.181127-12","first-page":"59","volume-title":"A case of aqueductal stenosis with acute progressive hydrocephalus during pregnancy","author":"Watanabe","year":"2005","journal-title":"No Shinkei Geka"},{"key":"key-10.4103\/1793-5482.181127-13","first-page":"801","volume-title":"Endoscopic third ventriculostomy for the treatment of obstructive hydrocephalus during pregnancy","author":"Riffaud","year":"2006","journal-title":"Obstet Gynecol"},{"key":"key-10.4103\/1793-5482.181127-14","first-page":"214","volume-title":"Large vestibular schwannomas presenting during pregnancy: Management strategies","author":"Shah","year":"2014","journal-title":"J Neurol Surg B Skull Base"},{"key":"key-10.4103\/1793-5482.181127-15","doi-asserted-by":"crossref","unstructured":"Spennato P, Tazi S, Bekaert O, Cinalli G, Decq P. Endoscopic third ventriculostomy for idiopathic aqueductal stenosis. World Neurosurg 2013;79 (2 Suppl): S21.e13-20.","DOI":"10.1016\/j.wneu.2012.02.007"},{"key":"key-10.4103\/1793-5482.181127-16","first-page":"29","volume-title":"Stenosis of the aqueduct of Sylvius.Etiology and treatment","author":"Hirsch","year":"1986","journal-title":"J Neurosurg Sci"},{"key":"key-10.4103\/1793-5482.181127-17","first-page":"1","volume-title":"Anatomopathology of non-tumoral aqueductal stenosis","author":"Jellinger","year":"1986","journal-title":"J Neurosurg Sci"},{"key":"key-10.4103\/1793-5482.181127-18","first-page":"75","volume-title":"Quality of life in obstructive hydrocephalus: Endoscopic third ventriculostomy compared to cerebrospinal fluid shunt","author":"Kulkarni","year":"2010","journal-title":"Childs Nerv Syst"},{"key":"key-10.4103\/1793-5482.181127-19","first-page":"1469","volume-title":"Cardiovascular function before, during, and after the first and subsequent pregnancies","author":"Clapp","year":"1997","journal-title":"Am J Cardiol"},{"key":"key-10.4103\/1793-5482.181127-20","doi-asserted-by":"crossref","unstructured":"Gordon MC. Maternal physiology. In: Gabbe SG, Niebyl JR, Simpson JL, editors. Obstetrics: Normal and Problem Pregnancies.5th ed. London: Churchill Liverstone; 2007.","DOI":"10.1016\/B978-0-443-06930-7.50005-0"},{"key":"key-10.4103\/1793-5482.181127-21","first-page":"139","volume-title":"The cerebral circulation during pregnancy: Adapting to preserve normalcy","author":"Johnson","year":"2015","journal-title":"Physiology (Bethesda)"},{"key":"key-10.4103\/1793-5482.181127-22","first-page":"104","volume-title":"Changes in flow velocity, resistance indices, and cerebral perfusion pressure in the maternal middle cerebral artery distribution during normal pregnancy","author":"Belfort","year":"2001","journal-title":"Acta Obstet Gynecol Scand"},{"key":"key-10.4103\/1793-5482.181127-23","first-page":"3229","volume-title":"Relaxin causes selective outward remodeling of brain parenchymal arterioles via activation of peroxisome proliferator-activated receptor-\u03b3","author":"Chan","year":"2011","journal-title":"FASEB J"},{"key":"key-10.4103\/1793-5482.181127-24","first-page":"329","volume-title":"Cerebral vascular adaptation to pregnancy and its role in the neurological complications of eclampsia","author":"Cipolla","year":"1985","journal-title":"J Appl Physiol ("},{"key":"key-10.4103\/1793-5482.181127-25","doi-asserted-by":"crossref","unstructured":"Nevo O, Soustiel JF, Thaler I. Maternal cerebral blood flow during normal pregnancy: A cross-sectional study. Am J Obstet Gynecol 2010;203:475.e1-6.","DOI":"10.1016\/j.ajog.2010.05.031"},{"key":"key-10.4103\/1793-5482.181127-26","first-page":"904","volume-title":"Maternal middle cerebral artery velocimetry in normal pregnancy and postpartum","author":"Serra-Serra","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"key":"key-10.4103\/1793-5482.181127-27","first-page":"445","volume-title":"Maternal middle cerebral artery blood flow velocity variation with gestational age","author":"Williams","year":"1994","journal-title":"Obstet Gynecol"},{"key":"key-10.4103\/1793-5482.181127-28","first-page":"907","volume-title":"Cerebrospinal fluid pressure in labor","author":"Hopkins","year":"1965","journal-title":"Am J Obstet Gynecol"},{"key":"key-10.4103\/1793-5482.181127-29","first-page":"19","volume-title":"Change in brain size during and after pregnancy: Study in healthy women and women with preeclampsia","author":"Oatridge","year":"2002","journal-title":"AJNR Am J Neuroradiol"},{"key":"key-10.4103\/1793-5482.181127-30","first-page":"263","volume-title":"Cesarean section in spinal anesthesia on a patient with mesencephalic tumor and ventriculoperitoneal drainage \u2013 A case report","author":"Hirs","year":"2012","journal-title":"Korean J Anesthesiol"},{"key":"key-10.4103\/1793-5482.181127-31","first-page":"271","volume-title":"Ventriculoperitoneal shunt and pregnancy","author":"Olatunbosun","year":"1992","journal-title":"Int J Gynaecol Obstet"},{"key":"key-10.4103\/1793-5482.181127-32","first-page":"139","volume-title":"Maternal postpartum group B beta-hemolytic Streptococcus ventriculoperitoneal shunt infection","author":"Kane","year":"2004","journal-title":"Arch Gynecol Obstet"},{"key":"key-10.4103\/1793-5482.181127-33","first-page":"350","volume-title":"Delayed-onset postpartum meningitis due to group B Streptococcus","author":"Fox","year":"1994","journal-title":"Clin Infect Dis"},{"key":"key-10.4103\/1793-5482.181127-34","first-page":"134","volume-title":"Maternal neurosurgical shunts and pregnancy outcome","author":"Landwehr","year":"1994","journal-title":"Obstet Gynecol"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.4103\/1793-5482.181127.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:48:28Z","timestamp":1663202908000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.4103\/1793-5482.181127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":34,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2022,9,14]]},"published-print":{"date-parts":[[2018,3]]}},"URL":"https:\/\/doi.org\/10.4103\/1793-5482.181127","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}