title: [Do differences exist in the neurosurgical handling of intracranial lesions of pregnant patient? Outcomes of our experience and literature review].
abstract: OBJECTIVE
  The main objective of our work is to revise our neurosurgical experience in pregnant patient and to carry out a revision of the related literature in order to optimize the neurosurgical handling of these kind of patients.
  
  
  METHODS
  Retrospective study between august 1993 and June 2010. We included patients who were pregnant at the time and who presented any trace of cranial neurosurgical or spinal disease.
  
  
  RESULTS
  The research includes the cases of 12 patients aged between 17 and 37 years old with an average age of 28.8 years old. The average gestation period was of 24.17 weeks, finding 50% of the patients within their third three-month period of pregnancy at the moment of diagnosis, 25% in their second three-month period and the remaining 25% in their first three-month period. The mean follow-up duration for this series was 84 months. 4 of them presented brain vascular lesions, 5 presented brain tumor lesions, 1 of them presented Chiari malformation, one lumbar disc herniation and 1 patient suffered from traumatic intracraneal hemorrhage. 8 of the 12 patients were subjected to neurosurgical procedures under general anesthetic, 2 for aneurysm embolizations and 2 for conservative treatments. Between the neurosurgical procedures 6 craniotomies were done, of wich 4 were to resection of the tumor and 2 for aneurysm clippings. There were done a transesfenoidal approach and a lumbar microdiscectomy. 2 of the 6 patients given craniotomies required external ventricular drainage before the operation. 5 elective cesareans were done in the group of patients given the craniotomies whilst of the rest the pregnancy was allowed to bring to term for reasons of pulmonary maturity. In our patients there were no cases of therapeutic abortion. There was found no morbidity no mortality neither in the mother nor in the fetus related to surgery.
  
  
  CONCLUSIONS
  In our experience with pregnant patients who suffered from neurosurgical lesion and in the experience we got from the revision of the related literature, the surgery of intracranial lesions is well tolerated by the mothers and the fetus. It must though be considered, the possibility of labor through cesarean depending on the fetus' lung maturity.
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario de Alicante, Alicante, España. Electronic address: mikel1972@hotmail.com.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Caminero-Canas
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Navarro-Moncho
authors.forename: Víctor
authors.initials: V
authors.lastname: Fernández-Cornejo
authors.forename: José
authors.initials: J
authors.lastname: Sánchez-Payá
authors.forename: Pedro
authors.initials: P
authors.lastname: Moreno-López
mesh_terms: D001139:Arnold-Chiari Malformation / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D003399:Craniotomy; D005260:Female; D006801:Humans; D019635:Neurosurgical Procedures; D011247:Pregnancy; D012189:Retrospective Studies