Management and pathophysiology of meningiomas during pregnancy. Literature review and case report

Abstract

Introduction: Intracranial tumors diagnosed during pregnancy can cause complications and aggravation for both pregnant and the baby. Tumors are often confused with the diagnosis of eclampsia, therefore involve cautious analysis. Thus, characteristics such as high blood pressure, seizures, intracranial hypertension increase the level of severity of the tumors in question. Fast and efficient diagnosis is of paramount importance for the best outcomes in cases of intracranial tumors in pregnancy. Case Presentation: A 33-year-old primiparous patient G1P0A0, previously healthy, diagnosed with gestational hypertension, evolved during pregnancy with pre-eclampsia refractory to drug treatment. Computed tomography scan of the skull showed a giant sphenoid wing meningioma. At 38 weeks of gestation, the patient presented with a seizure and was admitted to the maternity ward, the examination of eye fundus showed edema of the papillae. In the week following delivery, the patient underwent craniectomy with total meningioma resection. Methods: We performed a literature review on Medline database using as keywords “meningiomas” and “pregnancy” to carry out our search, and 211 articles were found, with only 6 used in this paper, which were further compared with our case. Conclusion: Meningiomas diagnosed during pregnancy, although rare, require several precautions to preserve mother and baby’s lives. Furthermore, given the gestational period and hormonal changes, tumors undergo changes in their functional and anatomical characteristics. Treatment and diagnosis must be quick and efficient, taking into account the gestation time and tumor location.