Cerebellar Hemangioblastoma Symptomatic During Pregnancy: A Short Review

Background: Symptomatic hemangioblastoma of the posterior cranial fossa presenting during the pregnancy is very rare. Hemangioblastoma may presents with persistent nausea and vomiting during pregnancy, which may be misinterpreted to be caused by hyperemesis gravidarum, which can further delay the diagnosis of raised intracranial pressure. Previously very few isolated cases of neurosurgical intervention with good outcome is reported in literature, Aim of study: To analyze the effect of VP shunt in case of symptomatic posterior fossa hemanagioblastoma in a pregnant women. Result: A 28-yearold female with 22weeks pregnanc, presented with a history of progressive headache, vomiting and diplopia of 4weks duration. She developed ataxia and minimal weakness one week prior to admission. Neuroimaging revealed hemangioblastoma. She underwent ventriculoperitoneal shunt procedure in view of poor neurological status. However, she showed progressive worsening of the neurological symptoms despite ventriculoperitoneal shunt surgery. Finally she was takenup for emergency midline suboccipital craniectomy and complete excision of right cerebellar hemangioblastoma. After removal of cerebellar hemangioblastoma, she made unremarkable recovery. She delivered a healthy male baby at 37 week of gestation by normal vaginal delivery. Summary: Cerebellar hemangioblastomas becoming symptomatic in second trimester pregnancy may warrant CSF diversion surgery and few cases even need definitive excision surgery for haemangioblastoma can be associated with good maternal and foetal outcome. So treating obstetric surgeon and neurosurgeon should consider surgical intervention can yield good outcome.