skip to main content

A 23-Year-Old Woman with Cerebellopontine Tumor Angle Sectio Caesaria Trans-peritoneal Profunda Surgery Over Oligohydramnios Indication

Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Received: 4 Apr 2023; Revised: 7 Jun 2024; Accepted: 20 Jun 2024; Published: 26 Aug 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Abstract

Background: Primary tumor are rarely found in pregnancy. Treatment for intracranial tumors in pregnant woman is a challenge for anesthesiologists, obstetricians and neurosurgeons. A large size cerebellopontine angle (CPA) tumor can suppress the brain stem structure and cause death if not treated immediately. This makes the way we treat patients, when the delivery time and the surgical intervention we choose to be quite difficult.

Case: A 23 years-old female patient using general anesthesia (GA) to accommodate profunda trans-peritoneal cesarean section (SCTP) in a 36 weeks pregnancy age, G1P0A0, ASA IIIE with CPA tumor and oligohydramnions.

Disscussion: Brain tumor usually grow rapidly during pregnancy due to fluid retention, increased blood volume, and hormonal changes. There is no specific guidelines that explain the treatment of intracranial tumor in pregnancy. This patient suffers from CPA tumor and oligohydramnions so SCTP is required. We use GA for SCTP because it is safe for patients with intracranial tumor.

Conclusion: Female G1P0A0, 23 years old, 36 weeks pregnancy age with CPA tumor was consulted by Obstetricians to Anesthesiologists to do SCTP with GA.

Fulltext
Keywords: cerebellopontine angle tumor; general anesthesia; pregnancy; oligohydramnions; SCTP

Article Metrics:

  1. Bharti N, Kashyap L, Mohan VK. Anesthetic management of a parturient with cerebellopontine-angle meningioma. Int J Obstet Anesth [Internet]. 2002 Jul 1; 11(3):219–21. Available from: https://doi.org/10.1054/ijoa.2001.0941
  2. Haas JF, Jänisch W, Staneczek W. Newly diagnosed primary intracranial neoplasms in pregnant women: a population-based assessment. J Neurol Neurosurg Psychiatry. 1986 Aug; 49(8):874–80
  3. Wu T, Qu P-R, Zhang S, Li S-W, Zhang J, Wang B, et al. The clinical treatment and outcome of cerebellopontine angle medulloblastoma: a retrospective study of 15 cases. Sci Rep [Internet]. 2020 Jun 17; 10(1):9769. Available from: https://pubmed.ncbi.nlm.nih.gov/32555264
  4. Patel N, Wilkinson J, Gianaris N, Cohen-Gadol AA. Diagnostic and surgical challenges in resection of cerebellar angle tumors and acoustic neuromas. Surg Neurol Int. 2012;3:17
  5. Son DW, Choi CH, Cha SH. Epidermoid Tumors in the Cerebellopontine Angle Presenting with Trigeminal Neuralgia. J Korean Neurosurg Soc [Internet]. 2010 Apr; 47(4):271–7. Available from: https://doi.org/10.3340/jkns.2010.47.4.271
  6. Chu C-K, Tseng H-M, Young Y-H. Clinical presentation of posterior fossa epidermoid cysts. Eur Arch Oto-Rhino-Laryngology Head Neck [Internet]. 2006; 263(6):548–51. Available from: https://doi.org/10.1007/s00405-005-0005-7
  7. Akhavan-Sigari R, Bellinzona M, Becker H, Samii M. Epidermoid cysts of the cerebellopontine angle with extension into the middle and anterior cranial fossae: surgical strategy and review of the literature. Acta Neurochir (Wien) [Internet]. 2007; 149(4):429–32. Available from: https://doi.org/10.1007/s00701-007-1117-1
  8. Zwierzyńska K, Bartoszewicz R, Morawski K, Niemczyk K. Cerebellopontine Angle Epidermoid Cyst. Case Report. Pol Review of Otorhinolaryngology. 2015; 4(1):48–51
  9. Stocchetti N, Roux P Le, Vespa P, Oddo M, Citerio G, Andrews PJ, et al. Clinical review: Neuromonitoring - an update. Crit Care [Internet]. 2013; 17(1):201. Available from: https://doi.org/10.1186/cc11513
  10. Samii M, Gerganov VM. Tumors of the cerebellopontine angle. Handb Clin Neurol. 2012; 105:633–9
  11. Renowden S. Imaging of the cerebello-pontine angle. Pract Neurol. 2014 Oct; 14(5):e2
  12. Swartz JD. Lesions of the cerebellopontine angle and internal auditory canal: diagnosis and differential diagnosis. Semin Ultrasound CT MR. 2004 Aug; 25(4):332–52
  13. Huang MY, Vermeulen S. Clinical perspectives regarding patients with internal auditory canal or cerebellopontine angle lesions: surgical and radiation oncology perspectives. Semin Ultrasound CT MR. 2003 Jun; 24(3):124–32
  14. Spena G, Sorrentino T, Altieri R, Zinis LR de, Stefini R, Panciani PP, et al. Early-Career Surgical Practice for Cerebellopontine Angle Tumors in the Era of Radiosurgery. J Neurol Surg B Skull Base. 2018 Jun; 79(3):269–81
  15. Tonn JC, Schlake HP, Goldbrunner R, Milewski C, Helms J, Roosen K. Acoustic neuroma surgery as an interdisciplinary approach: a neurosurgical series of 508 patients. J Neurol Neurosurg Psychiatry. 2000 Aug; 69(2):161–6
  16. Heier LA, Comunale JPJ, Lavyne MH. Sensorineural hearing loss and cerebellopontine angle lesions. Not always an acoustic neuroma--a pictorial essay. Clin Imaging. 1997; 21(3):213–23
  17. Larson TL. Understanding the posttreatment imaging appearance of the internal auditory canal and cerebellopontine angle. Semin Ultrasound CT MR. 2003 Jun; 24(3):133–46
  18. Jagannathan S, Krovvidi H. Anaesthetic considerations for posterior fossa surgery. Contin Educ Anaesth Crit Care Pain [Internet]. 2014 Oct 1; 14(5):202–6. Available from: https://doi.org/10.1093/bjaceaccp/mkt056
  19. Porter JM, Pidgeon C, Cunningham AJ. The sitting position in neurosurgery: a critical appraisal. Br J Anaesth. 1999 Jan; 82(1):117–28
  20. Thibault M, Girard F, Moumdjian R, Chouinard P, Boudreault D, Ruel M. Craniotomy site influences postoperative pain following neurosurgical procedures: a retrospective study. Can J Anaesth. 2007 Jul; 54(7):544–8
  21. Chang L, Looi-Lyons L, Bartosik L, Tindal S. Anesthesia for cesarean section in two patients with brain tumours. Can J Anesth [Internet]. 1999; 46(1):61–5. Available from: https://doi.org/10.1007/BF03012517
  22. Korula G, Farling P. Anesthetic Management for a Combined Cesarean Section and Posterior Fossa Craniectomy. J Neurosurg Anesthesiol [Internet]. 1998; 10(1). Available from: https://journals.lww.com/jnsa/Fulltext/1998/01000/Anesthetic_Management_for_a_Combined_Cesarean.7.aspx
  23. Tewari KS, Cappuccini F, Asrat T, Flamm BL, Carpenter SE, DiSaia PJ, et al. Obstetric emergencies precipitated by malignant brain tumors. Am J Obstet Gynecol [Internet]. 2000 May 1; 182(5):1215–21. Available from: https://doi.org/10.1016/S0002-9378(00)70188-8
  24. Iddrisu M, Khan ZH. Anesthesia for cesarean delivery: general or regional anesthesia: a systematic review. Ain-Shams J Anesthesiol [Internet]. 2021; 13(1):1. Available from: https://doi.org/10.1186/s42077-020-00121-7
  25. Giannini A, Bricchi M. Posterior fossa surgery in the sitting position in a pregnant patient with cerebellopontine angle meningioma. Br J Anaesth [Internet]. 1999; 82(6):941–4. Available from: http://dx.doi.org/10.1093/bja/82.6.941
  26. Bacon RC, Razis T effect of propofol sedation in pregnancy on neonatal condition PA. The effect of propofol sedation in pregnancy on neonatal condition. Anaesthesia [Internet]. 1994 Dec 1; 49(12):1058–60. Available from: https://doi.org/10.1111/j.1365-2044.1994.tb04356.x
  27. Bendiksen A, Larsen LM. Convulsions, ataxia and hallucinations following propofol. Acta Anaesthesiol Scand [Internet]. 1998 Jul 1; 42(6):739–41. Available from: https://doi.org/10.1111/j.1399-6576.1998.tb05312.x
  28. Fouche PF, Meadley B, StClair T, Winnall A, Stein C, Jennings PA, et al. Temporal changes in blood pressure following prehospital rapid sequence intubation. Emerg Med J. 2022 Jun; 39(6):451–6

Last update:

No citation recorded.

Last update: 2024-08-31 09:58:48

No citation recorded.