Management strategies for acute brain lesions presenting during pregnancy: a case series

Abstract

The management of pregnant patients with acute brain lesions should be individualised and multidisciplinary. As it is difficult to allocate a single, general treatment protocol to pregnant patients with brain lesions, we suggest the following guidelines: for patients in the second and early third trimesters, it is safe to perform a craniotomy first and allow the patient to complete a full term pregnancy. For patients at 34 weeks or more of gestation, emergency CS followed by a craniotomy is recommended. For patients in the 1st trimester, it is advisable to terminate the pregnancy to allow safe management, although the laws governing this will vary from country to country. For patients with benign tumours who respond to corticosteriods, it is possible to complete the pregnancy and postpone surgery until after delivery.