Cerebral Arteriovenous Malformation, Cerebral Cavernoma, and Cerebral Aneurysm: Management and Outcome During Pregnancy and Puerperium with Focus on Neurosurgical Side

Abstract

Background: Cerebral cavernoma, cerebral arteriovenous malformation, and incidental cerebral aneurysm are rare but challenging conditions during pregnancy and puerperium. The primary diagnostic and identification techniques used to determine and evaluate these conditions in terms of morphology, location, and presentation are brain CT scan, MRI, and DSA. With ideal treatment of these conditions still unclear, neurosurgery is the most commonly preferred intervention technique. Objective: The aim of extracting data from the published studies to identify the most common neurosurgical procedures used for successful management and outcomes of CCM, cerebral AVM, and incidental cerebral aneurysms during pregnancy and puerperium. Methods: It was performed as comprehensive search into PubMed, Google Scholar, Science Direct, PubMed Central, Medline, and Research Gate databases for studies published between January 2000 to 20th January 2022. The search terms were "Cerebral cavernoma" or "cavernous cerebral malformation" or "CCM" or "cavernoma in pregnancy and puerperium"; "cerebral arteriovenous malformations" or "arteriovenous malformations" or "AVM"; "cerebral incidental aneurysm" or "intracranial aneurysm" or "incidental aneurysm" or "cerebral aneurysm in pregnancy"; "intracranial vascular malformations"; "neurosurgical treatments in pregnancy and puerperium"; "management of vascular malformation." Results: A total of 11 studies met our inclusion criteria and were included for the review. From the studies reviewed, the significant neurosurgical intervention performed among the participants were craniotomy, surgical resection, endovascular techniques, surgical clipping, surgical evacuation, embolization, and dissection. Conclusion: It concluded that effective management and treatment must be done independently and specific to each case presented. The multidisciplinary treatment option is fundamental for successful management outcomes during pregnancy and puerperium.