Anaesthetic Management of a Parturient with Meningioma and an Obstructive Hydrocephalus
DOI:
https://doi.org/10.30442/ahr.1003-10-250Abstract
A 40-year-old Gravida 4, Para 3 Hb AA patient with a history of one previous caesarean delivery presented at 30 weeks + 1 day of gestation with a CT scan confirmed diagnosis of meningioma with obstructive hydrocephalus. She had caesarean delivery under general anaesthesia. Taming of suxamethonium was done for endotracheal intubation, and the pain was managed with a transversus abdominis plane block. This study highlights anaesthetic management and the role of combining different techniques in managing meningioma in a resource-poor environment. The challenges to be highlighted include intubating a patient with a raised intracranial pressure, anaesthetic management of delivering a foetus without compromising the neurophysiological state of the mother and maintaining a stable haemodynamic state as there is a shift in autoregulation.
References
Dumitrescu BC, Tataranu LG, Gorgan MR. Pregnant woman with an intracranial meningioma - case report and review of the literature. Rom. Neurosurg 2014;21:489–496.
Hortobágyi T, Bencze J, Murnyák B, Kouhsari MC, Bognár L, Marko-Varga G. Pathophysiology of Meningioma Growth in Pregnancy. Open Med (Wars). 2017;12:195-200. https://doi.org/10.1515/med-2017-0029
Boyle-Walsh E, Shenkin A, White MC, Fraser WD. Effect of glycoprotein and protein hormones on human meningioma cell proliferation in vitro. J Endocrinol 1995;145:155–161.
Cushing H, Eisenhardt L. Meningiomas arising from the tuberculum sellae. Arch Ophth 1929;1:168–205.
Kanaan I, Jallu A, Kanaan H. Management Strategy for Meningioma in Pregnancy. A Clinical Study. Skull Base 2003;13:197–203. https://doi.org/10.1055/s-2004-817695
Agbeno EK, Osarfo J, Ashong J, Anane-Fenin B, Okai E, Ofori AA et al. Determinants of preterm survival in a tertiary hospital in Ghana: A ten-year review. PLoS ONE;16:e0246005. https://doi.org/10.1371/journal.pone.0246005
Sahu S, Lata I, Gupta D. Management of a pregnant female with meningioma for craniotomy. J Neurosci Rural Pract 2010;1:35-37. https://doi.org/10.4103/0976-3147.63101
Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, [List the first six authors before et al] et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obst Gynecol 2016;215:103.e1-103.e14. https://doi.org/10.1016/j.ajog.2016.01.004
Shiro R, Murakami K, Miyauchi M, Sanada Y, Matsumura N. Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review. Medicina (Kaunas) 2021;57:613. https://doi.org/10.3390/medicina57060613
Gaiser R. Evaluation of the Pregnant Patient. In: Longnecker DE, Brown DL, Newman MF, Zapol WM. (eds). Anesthesiology. Second Edition. McGraw Hill. 2012. https://accessanesthesiology.mhmedical.com/content.aspx?bookid=490§ionid=40114704 Accessed 24 July 2023.
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