{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:21:15Z","timestamp":1787653275451,"version":"build-2736575974"},"reference-count":41,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Neurosurgical emergencies in the obstetric setting pose considerable challenges. Decision-making involves deliberations on the gestational age, critical nature of the illness, timing of surgery, maternal positioning during neurosurgery, anesthesiologic strategies, monitoring of the pregnancy during surgery, and the mode of delivery. The present study discusses the management and ethical dilemmas encountered during the management of six obstetric patients with neurosurgical emergencies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>A retrospective review of all neurosurgical operations performed between January 2016 and December 2022 were included in the study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>This study includes a series of six pregnant women who presented with neurosurgical emergencies, secondary to freshly diagnosed pathologies in the period 2016\u20132022. The mean maternal age was 31.33 years. Four of the six patients were in the third semester and two were in the second trimester. The underlying etiologies were as follows: spontaneous intracerebral hypertensive hemorrhage (1), obstructive hydrocephalus due to shunt malfunction (1), brain tumor (02), and compressive spinal cord myelopathy due to tumors (02). Three patients who were near term underwent lower cesarean section followed by emergency neurosurgical procedure in the same sitting. Two second trimester patients continued their pregnancy after the emergency neurosurgical operation. In one patient, in whom a brain tumor was diagnosed near term, underwent neurosurgery 1 week after successful cesarean section. All the six mothers and fetus recovered well, ex3cept two patients who have persisting residual deficits.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Treatment of neurosurgical emergencies during pregnancy needs to be customized depending on the clinical condition of the pregnant woman, prognosis of the disease, gestational age and the status of the pregnancy. With careful planning, timely intervention, consultative decision making and it is possible to achieve the ultimate goal \u2013 which is to protect and safeguard the mother and preserve and deliver a viable fetus.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1076_2022","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T08:49:37Z","timestamp":1682671777000},"page":"151","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neurosurgical emergencies during pregnancy \u2013 Management dilemmas"],"prefix":"10.25259","volume":"14","author":[{"given":"Deepika","family":"Choudhary","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Mohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arla Sai","family":"Varsha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Hegde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Menon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"10.25259\/SNI_1076_2022\/ref-1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1097\/AOG.0b013e31820eede9","article-title":"474: Nonobstetric surgery during pregnancy","volume":"117","author":"ACOG Committee Opinion","year":"2011","journal-title":"Obstet Gynecol"},{"key":"10.25259\/SNI_1076_2022\/ref-2","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1227\/00006123-198503000-00014","article-title":"Microsurgical removal of suprasellar meningiomas","volume":"16","author":"Al-Mefty","year":"1985","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1076_2022\/ref-3","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1053\/j.sult.2011.09.002","article-title":"Pregnancy-induced acute neurologic emergencies and neurologic conditions encountered in pregnancy","volume":"33","author":"Alvis","year":"2012","journal-title":"Semin Ultrasound CT MR"},{"key":"10.25259\/SNI_1076_2022\/ref-4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s12028-018-0501-4","article-title":"Spontaneous intracranial hemorrhage in pregnancy: A systematic review of the literature","volume":"30","author":"Ascanio","year":"2019","journal-title":"Neurocrit Care"},{"key":"10.25259\/SNI_1076_2022\/ref-5","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/0002-9378(76)90575-5","article-title":"Maternal deaths due to spontaneous subarachnoid hemorrhage","volume":"125","author":"Barno","year":"1976","journal-title":"Am J Obstet Gynecol"},{"key":"10.25259\/SNI_1076_2022\/ref-6","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1212\/01.wnl.0000228277.84760.a2","article-title":"Intracerebral hemorrhage in pregnancy: Frequency, risk factors, and outcome","volume":"67","author":"Bateman","year":"2006","journal-title":"Neurology"},{"key":"10.25259\/SNI_1076_2022\/ref-7","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/foc.2005.19.3.8","article-title":"Pregnancy-related vertebral hemangioma. 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