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
{"title":"Intraoperative monitoring during awake craniotomy for glioblastoma resection in the second trimester of pregnancy. A case report and literature review","authors":"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","doi":"10.1016/j.cnp.2025.02.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Significance</h3><div>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.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 63-69"},"PeriodicalIF":2.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Neurophysiology Practice","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2467981X25000071","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
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.
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.