Abstract INTRODUCTION Vestibular Schwannomas (VS) are intracranial tumors of the nervous system originating from peripherally myelinating Schwann cells. There are sparse reports of this tumor presenting in pregnant patients but many of the cardinal symptoms of pregnancy overlap with the presentation of VS. For this reason, we systematically reviewed reports of VS in pregnant patients to identify the most specific clinical symptoms to aid diagnosis of and address management considerations for this population. METHODS Our systematic review was performed according to PRISMA guidelines. The data extracted includes study characteristics, symptom presence and onset relative to tumor diagnosis, tumor size, treatment modality, complications, and maternal/fetal health outcomes. This data was analyzed for overlap with commonly presenting symptoms and current management trends. RESULTS Sixteen papers between 1967 and 2018 reported a total of 26 pregnant patients who met criteria for inclusion. The most common presenting symptoms were hearing loss (76.9%), ataxia (42.3%), headache (38.5%), and vomiting (38.5%). The symptoms that presented with the longest duration were dizziness/vertigo (145.33 weeks), tinnitus (155 weeks), and hearing loss (145.67 weeks). The most common complications were post-op facial paralysis (46.2%), hydrocephalus (23.1%), and post-op hearing loss (19.2%). CONCLUSIONS A heightened clinical suspicion for VS in pregnant patients is needed due to the large overlap of cardinal symptoms of pregnancy and VS presentation. The way pregnancy changes patients’ normal physiology should be considered when determining optimal management. We hope that this review will improve diagnostic accuracy and prevent complications in pregnant patients with VS.
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