Intraoperative monitoring during awake craniotomy for glioblastoma resection in the second trimester of pregnancy. A case report and literature review

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI:10.1016/j.cnp.2025.02.006

Bayron A. Sandoval-Bonilla , Isela Valverde Luna , Aleida Arritola-Uriarte , Daniel San-Juan , Ricardo García-Iturbide , Alma Edith Gress Mendoza , Lorely Cumplido Pulido , Lizzette Hinojosa González , Alfredo Lara Bahena , Maria F. De la Cerda Vargas

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引用次数: 0

Abstract

Objective

To demonstrate the feasibility and safety of awake craniotomy (AC) with intraoperative neurophysiological monitoring (IONM) for glioblastoma (GB) resection in a pregnant patient, ensuring preservation of neurological functions and fetal well-being.

Methods

A 27-year-old gravida 2, para 1 woman presented at 19.4 weeks of pregnancy with severe headaches and a generalized tonic-clonic seizure. Imaging confirmed a malignant glioma, and an interdisciplinary team opted for AC with IONM to achieve maximal tumor resection while minimizing maternal and fetal risks.

Results

Surgery was performed during the second trimester with successful gross total resection of the tumor. IONM strategies preserved neurological function, and fetal well-being was maintained. Postoperative evaluations showed no complications, and the patient was discharged in improved condition.

Conclusions

AC with IONM is a viable and safe surgical approach for GB resection during pregnancy. Tailoring the surgical plan by considering gestational age, maternal health, and fetal safety is crucial.

Significance

This case highlights the importance of multidisciplinary management in optimizing outcomes for pregnant patients with GB, contributing valuable insights to the limited literature on neurosurgical interventions during pregnancy.

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妊娠中期清醒开颅术中胶质母细胞瘤切除术的术中监测。病例报告及文献复习

目的探讨清醒开颅术（AC）联合术中神经生理监测（IONM）用于妊娠患者胶质母细胞瘤（GB）切除术的可行性和安全性，确保胎儿神经功能和胎儿健康。方法1例27岁妊娠2期妇女，妊娠19.4周时出现严重头痛和全身性强直阵挛发作。影像学证实了恶性胶质瘤，一个跨学科的团队选择了AC与IONM，以实现最大程度的肿瘤切除，同时最大限度地降低了母亲和胎儿的风险。结果妊娠中期手术成功切除肿瘤。IONM策略保留了神经功能，并维持了胎儿的健康。术后评估显示无并发症，患者出院时病情好转。结论sac联合IONM是妊娠期GB切除术可行、安全的手术方式。通过考虑胎龄、产妇健康和胎儿安全来调整手术计划是至关重要的。本病例强调了多学科管理在优化妊娠期GB患者预后中的重要性，为有限的妊娠期神经外科干预文献提供了有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.