VESTIBULAR SCHWANNOMA IN A PUERPERAL WOMAN

Abstract

Vestibular schwannoma rarely present in pregnant and puerperal women. The diagnosis and management of these tumours present a therapeutic challenge. A 20 year old P1L1 delivered by labour natural was referred from a local PHC on the 2nd post natal day with complaints of head-ache, giddiness, unsteadiness of gait, blocked sensation in the left ear and blurring of vision since two weeks. MRI showed a (L) cerebello pontine angle mass extending into the (L) external acoustic meatus, compressing the (L)cerebellum, pons and medulla with moderate dilatation of lateral and third ventricles. (R) ventriculo peritoneal shunt was done. 15 days later  subtotal tumour excision was done through rectosigmoid approach. Immunohistochemistry confirmed vestibular schwannoma on cranial nerve VIII. Patient was discharged on the 15th post operative day with no new neurological deficit.The treatment options for vestibular schwannoma  depends on the patient's stage of pregnancy and neurologic status. If the patient is neurologically stable, the best  treatment option is to delay resection until after delivery. If resection is necessary during pregnancy, the second  trimester is the optimal time for surgery.