Pregnant patients with severe headaches – don’t forget brain tumours!

Although sometimes innocuous, headaches in pregnancy may be associated with serious, even life-threatening conditions, with diagnosis delayed due to nonspecific findings associated with normal pregnancy. Meningiomas are the most common primary tumours, have a strong female predisposition and are mostly benign. There is a paucity of information on the diagnosis and management of meningiomas during and after pregnancy. In this article, we describe two cases of meningioma with differing management, seen within a period of 6 months. In case one, iatrogenic preterm delivery of the baby at 33 weeks' gestation was executed to facilitate vision-saving neurosurgery. In our second case, delivery was at early term, with time allowed for postpartum re-evaluation before definitive neurosurgery.