Anaesthesia for Caesarean Section in a Patient with an Intracranial Arteriovenous Malformation

Intracranial haemorrhage from an arteriovenous malformation (AVM) during pregnancy is rare but may result in significant maternal and fetal morbidity and mortality. In the untreated patient with an AVM, the best mode of delivery remains debatable with most obstetricians preferring a caesarean section in order to avoid Valsalva manoeuvres associated with vaginal delivery. We describe the administration of epidural anaesthesia for such a parturient undergoing Caesarean section and the anaesthetic implications.