Anesthetic management of a parturient with cerebellopontine-angle meningioma

Cerebellopontine-angle meningioma is a rare intracranial neoplasm. It presents a difficult problem in pregnancy. A 27-year-old multigravida presented with headache, vomiting and visual disturbances at 30 weeks' gestation and cerebellopontine angle meningioma and hydrocephalus were diagnosed. A ventriculoperitoneal shunt was placed under general anesthesia to reduce the symptoms of raised intracranial pressure and to prevent the risk of cerebellar herniation. At 32 weeks a cesarean section was performed under general anesthesia and a healthy baby delivered. A smooth induction and maintenance of anesthesia along with lidocaine and mannitol were used to prevent a rise in intracranial pressure. The intraoperative and postoperative course was uneventful. Thus, immediate neurosurgical decompression improved the patient's condition, and allowed time for fetal maturity and uneventful delivery by cesarean section under general anesthesia. (C) 2002 Published by Elsevier Science Ltd.