The pregnant neuro surgical emergency patient is fortunately extremely rare. Management decisions in strictly neurosurgical terms are relatively straightforward, but surgical decisions will often be compromised by the needs of the developing baby and particularly the risks to it. The main problems are in the restrictions in anaesthesia and imaging, these specialities having far more experience in dealing with a pregnant patient than our own. The fear of damaging the baby and the consequent medico-legal litigation risk poses significant restrictions on what these specialties are prepared to do. Ultimately it comes down to clinical urgency assessed against risk to the baby.
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