Specifics of Caring for a Pregnant Woman after Surgical Removal of a Brain Aneurysm – a Case Study

Abstract

Introduction. Arteriovenous malformations (AVMs) are developmental disorders of the intracranial vascular system which may increase in size over time, thereby leading to intracerebral hemorrhage. AVMs may often coexist with intracranial aneurysms.

Aim. The aim of this paper is to present the specifics of caring for a pregnant woman after surgical removal of an arteriovenous malformation and cerebral aneurysm, who underwent right hemispheric osteodural decompression and embolization of the front parietal region. The following research method was employed: an individual case study using the nursing process. The tools used included: interview, observation, analysis of medical records, and literature review.

Case Report. A G1P0 patient at 26 weeks of gestation was admitted to hospital due to sudden onset left-sided numbness and hemiparesis. A CT examination revealed, among other findings, intracerebral hemorrhage; angio-CT showed an arteriovenous malformation adjacent to the hematoma with an accompanying aneurysm. The pregnant patient underwent two complex surgeries (craniectomy and embolization). The total duration of hospitalization from admission to transfer to the labor room was 77 days. Based on the nursing process method, the following nursing problems were identified: risk of pressure ulcer development and impaired self-care resulting from left-sided paresis.

Discussion. The paper discussed the topic of AVMs, intracranial aneurysms, and hemorrhagic strokes. Statistics on the incidence of hemorrhagic strokes during pregnancy, management strategies in pregnant patients, and studies on the frequency of AVM-related strokes are also presented. The identified nursing problems and proposed management strategies are compared with clinical case reports available in Polish and international literature. The study was prepared in accordance with the principles of evidence-based medicine (EBM), enabling the inclusion of current scientific research and best clinical practices.

Conclusions. A pregnant woman who experiences complex clinical situations beyond her control represents a special case. The paper highlights the need for specialized neurological rehabilitation and ongoing cooperation of the interdisciplinary team. (JNNN 2026;15(2):69–77)