Nursing care of Sturge-Weber Syndrome (SWS), referred for Digital Subtraction Angiography (DSA)

Revathty1, Vijayalakshmi2, Devibala3

1Emergecny Ward Incharge, Kauvery Heart city, Trichy, Tamil Nadu

2Emergecny Ward Incharge, Kauvery Heart city, Trichy, Tamil Nadu

3Emergency Ward Staff Nurse, Kauvery Heart city, Trichy, Tamil Nadu

Abstract

A 26 years old patient came with the complaints of headache since past 14Years. Patient went to outside hospital, took MRI SCAN and came for further management for Kauvery Hospital.

Introduction

Sturge – Weber Syndrome (SWS) is a rare neurological condition characterized by abnormal development of the small blood vessels (called capillaries) in the brain, eyes, and skin.  In most cases, doctors diagnosis SWS in infants. But sometimes, diagnosis happens in order children and (rarely) in adults. In people with SWS, blood does not flow properly through these abnormal capillaries. This can also cause cerebral cortex atrophy (tissue loss in a part of the brain).

Digital Subtraction Angiography is a fluoroscopic technique used to clearly visualize the blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a “pre contrast image“or mask from subsequent images, once the contrast medium has been introduced into a structure; hence the term “Digital Subtraction Angiography” . It was first described in 1935, and in English sources in 1962, as a manual technique Digital technology made digital subtraction angiography practical, starting in the 1970s.

Background

A 26 years old female, known PCOD. History of left sided headache (parietal region) since 14years and history of numbness over left upper limb since 4years and history of sweating. She was evaluated in KMC specialty. On further evaluation and she was suspected to have Sturge Weber syndrome and was advised for cerebral DSA. After an informed written consent patient underwent cerebral DSA on 3/7/25.there was no procedural complications, Patient was stable after the procedure.

MRI

  • Few prominent flow voids in the left parieto occipital lobe.
  • Enlarged choroid plexus in left lateral ventricle likely Sturge-Weber syndrome.

Past Medical History: Tab. Meprate 10mg 1-0-1

Immediate care

  • On receiving to elective DSA procedure.
  • Vital signs assessed and BP (130/70MM/HG).
  • IV Line secured.
  • Duty doctor seen patient take history collection.
  • Duty doctor initial assessment was done explain high-risk poor prognosis and after discuss the further treatment for primary consultant.
  • Duty doctor has explained the condition to attenders.
  • Discuss general ward admission was done.

Diagnosis

Sturge-Weber syndrome

Nursing Management

  • To ensure that the patient received to emergency to safe timely and provide effective care nurses monitor the vital signs.
  • Nurses used AIDET technique (acknowledge, introduce duration, explanation and thank you) while communicating with patient and attenders to gain their confidence and improve the satisfaction level.
  • Explained to the procedure
  • To give psychological support to the patient and family members.
  • Patient shifting in DGW
  • Procedure consent was obtained
  • All blood reports are collected
  • Patient shifted to Cath lab on 03.07.2025
  • After finishing the procedure patient received Cath lab to DGW with stable condition.
  • There was no procedural and post procedural complications.
  • Bilateral DPA palpable.
  • Patient is stable after the procedure.
  • Patient condition improved she is being discharged in a stable state.

Discharged Advised

  • Medication advice
  • Daily activity advice
  • Review after one weeks.

Outcome

Following the DSA procedure for a patient with Sturge Weber syndrome, the outcome was good as the imaging clearly showed the extent of vascular malformation in the brain. This information will help guide further management and treatment decisions to optimize care for the patient. The procedure was completed without significant complications.

Reference

  • Comi AM. Update on Sturge –Weber syndrome: diagnosis, treatment, quantitative measures, and controversies. Lymphat Res Biol. 2007; 5(4): 257-264.
  • Rihani HT, Dalvin LA, Hodge DO, Pulido JS. Incidence of Sturge–Weber syndrome and associated ocular involvement in Olmsted County, Minnesota, United States. Ophthalmic Genet. 2020; 41(2): 108-124.
  • Ha A, Kim SH, Baek SU, Kim JS, Yoon HJ, Kim YK. Incidence of Sturge–Weber syndrome and risk of secondary glaucoma: a nationwide population-based study using a rare disease registry. Am J Ophthalmol. 2023; 247: 121-126.
  • Dymerska M, Kirkorian AY, Offermann EA, Lin DD, Comi AM, Cohen BA. Size of facial port-wine
  • Birthmark may predict neurologic outcome in Sturge–Weber syndrome. J Pediatric. 2017; 188: 205-209.
  • Lin DD, Gailloud P, McCarthy EF, Comi AM. Oromaxillofacial osseous abnormality in Sturge–Weber syndrome: case report and review of the literature. Am J Neuroradiol. 2006; 27(2): 274-277.
  • Eivazi B, Roessler M, Pfützner W, Teymoortash A, Werner JA, Happle R. Port-wine stains are more than skin-deep! Expanding the spectrum of extracutaneous manifestations of nevi flammei of the head and neck. Eur J Dermatol. 2012; 22(2): 246-251.
  • Sujansky E, Conradi S. Sturge–Weber syndrome: age of onset of seizures and glaucoma and the prognosis for affected children. J Child Neurol. 1995; 10(1): 49-58

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