Large parasagittal meningioma in a pregnant woman

Large parasagittal meningioma is rare in pregnant women. In this paper, we report the successful treatment of a pregnant woman with a large parasagittal meningioma. A 35-year-old woman in her 37th week of pregnancy presented with acute consciousness disturbances after experiencing headache and nausea for 2 weeks. We performed a successful cesarean delivery under general anesthesia, and immediately after the delivery, brain computed tomography was performed. The scan revealed a large tumor (8.3 × 6.8 × 7.1 cm3) in the left frontal region, thickening of the adjacent skull base, and perifocal edema. Twenty-four hours after the delivery, the patient underwent imaging studies, namely, magnetic resonance imaging and angiography. The parasagittal meningioma was removed through craniotomy, and the surgical outcome was highly satisfactory. Although meningioma is benign, the tumor mass can expand rapidly during pregnancy. In our patient, an early cesarean section was first performed for a successful delivery, and imaging studies and transarterial embolization of the tumor blood supply were performed prior to the second operation for craniotomy and total tumor excision. A multidisciplinary team was critical for successfully treating this patient.