J Neurol Surg A Cent Eur Neurosurg 2014; 75 - o005
DOI: 10.1055/s-0034-1382166

Brain Tumors Surgical Treatment and Pregnancy

S.К. Аkshulakov 1, G.I. Olenbay 1, N. A. Ryskeldiyev 1, A. Z. Doskaliev 1, D. A. Surdin 1
  • 1National Center for Neurosurgery, Astana, Kazakhstan

Introduction: In 75% cases tumors are progressing in reproductive age. Placenta is a powerful hormonal body stimulating the tumors growth. Maternal fatality is 24.3%. Aim: Formulate treatment tactics. Material and Methods: 22 women (2009-2014) were surgically treated with clinical symptoms mistakenly interpreted as an early preeclampsia - headache 100% and vomiting 42%. The treatment choice agreed with neurosurgeons, anesthesiologists and obstetricians. 14 of 22 patients surgically treated in postnatal period. Delivery performed by cesarean section, 6 patients produced fetus wastage, 2 (19-20 and 25-26 weeks) with surgical treatment under fetal ultrasound and obstetricians monitoring, performed with StealthStation and Medtronik navigation systems providing us with optimal access and visualization of low-grade gliomas with no clear boundaries and difficult location. Results: Glial tumors are prevail 9 of 22 (40.9%), 4 (44.4%) have fibrillar protoplasmic astrocytoma, 3 (33.3%) anaplastic astrocytoma, 2 (22.2%) glioblastoma multiforme, 4 (18.1%) meningiomas, 1 (25%) atypical meningioma, 2 (9.0%) hemangioblastoma anaplastic, 2 (9,0%) ependymoma. After 3 months CT and MRI showed total removal 12 (54.5%) and 9 (40.9%) subtotal removal. 1 (4.54%) - verifies the histological autopsy. One fatality case among 22, rated as (4.54%). Conclusion: Surgical treatment depends on neurological condition, location of tumor and gestation and is not an absolute indication for fetus wastage.