Management of intracranial lesions during pregnancy

Introduction. Intracranial lesions during pregnancy are very rare conditions in obstetrical and neurosurgical practice. There is no precise protocol for the management of intracranial lesions during pregnancy yet. The aim of this study was to elaborate on pregnant patients with intracranial pathology in order to achieve better outcomes in the future. Methods. This is a descriptive cross-sectional study conducted among patients presented with intracranial lesions at the Department of Neurosurgery at the National Academy of Medical Science, Bir Hospital. The data was collected. retrospectively from hospital data thirty patients with intracranial lesions during pregnancy from 2015 to 2024. We analyzed the treatment decisions and obstetrical and neurosurgical outcomes. All patients were evaluated with either computed tomography, magnetic resonance imaging, or both. Results. Among the admitted patients, the youngest patient was 20 years and the oldest was 42 years, of which 2, 13 and 15 patients were diagnosed in the first, second and third trimesters, respectively. The distribution of neurosurgical problems was as follows: subarachnoid haemorrhage (SAH) n=6, cerebral venous thrombosis (CVT) n=6, brain tumour n=5, trauma n=6, Intracranial haemorrhage (ICH) n=2, VP shunt n=2, tuberculoma n=1, neurocysticercosis n=1, and pituitary adenoma n=1. Fifteen patients (50%) underwent brain operation, eleven patients (36%) had conservative therapy, one patient died and four patients were terminated during pregnancy. Conclusion. Multidisciplinary teams are not only required to successfully diagnose and treat intracranial lesions but also to safeguard both the mother and child.