Therapeutic management of acoustic neurinoma during twin pregnancy: a case report.

BACKGROUND: Acoustic neuromas belong to relatively rare illnesses in pregnant women. A gradual worsening of the symptoms presents a serious challenge for an obstetrician, neurosurgeon and anesthesiologist, who must work together to provide a successful outcome for mother and newborn. CASE: A 33-year-old woman presented with gradually progressing visual inacuity in the 30th week of pregnancy. Magnetic resonance imaging showed a vestibular acoustic neuroma of cranial nerve VII on the right side. Because of the gradual worsening of vision, a cesarean section was performed in the 33rd week of pregnancy. On the 14th postoperative day a team of neurosurgeons performed a right suboccipital craniectomy and completely removed the tumor. CONCLUSION: The treatment of acoustic neuroma depends on the general health of a patient and the length of pregnancy. It seems that the best solution is separating the child delivery and neurosurgery in time, which is not always possible. If symptoms of intracranial compression quickly worsen, an immediate intervention is often required regardless of the pregnancy stage.