Case Report

Left hemiparesis due to space-occupying lesion in pregnancy

Luminto1, Ekarini Aryasatiani1, Mahendro Aji Panuntun2, Bobby Wirawan Hassan3, Tania Sananta4, Arya Elbert Neil5
1Department of Obstetrics and Gynecology, Tarakan Regional General Hospital, Jakarta, Indonesia, 2Department of Radiology Tarakan Regional General Hospital, Jakarta, Indonesia, 3Department of Neurosurgery Tarakan Regional General Hospital, Jakarta, Indonesia, 4Department of Neurology Tarakan Regional General Hospital, Jakarta, Indonesia, 5Clinical Clerkship Student of Obstetrics and Gynecology, Tarakan Regional General Hospital, Jakarta, Indonesia.

HIGHLIGHTS

1. Report findings of a case of “late diagnosed” space occupying lesion in pregnancy.
2. Until now, all the newest studies used in this case report still says that if a tumor needs to be removed when a woman is pregnant, the second trimester is the optimum period for both the mother and the fetus. This case report can be used as a reference for managing space occupying lesion cases according to the latest studies.

ABSTRACT

Objectives: The objective of this study is to present the findings from cases of space-occupying lesions (SOL) that were diagnosed late in pregnancy. This case report aims to highlight the importance of considering space-occupying lesions as a differential diagnosis in instances of hemiparesis during pregnancy, thereby raising clinical awareness and improving diagnostic accuracy.
Case Report: A female patient aged 30 years 34 weeks pregnant came with complaints of slurred speech since 3 months before entering the hospital accompanied by weakness in the left limbs since 3 months before entering the hospital. The patient felt weak and fell in the bathroom 2 times, at the office and at home. The patient had a history of taking aspilet for 1.5 months due to a misdiagnosis as a stroke in the Type B hospital and stopped when she came to the obstetric emergency room at Type A Hospital for the first time. Cardiothoracograph examination shows a picture of a silent baby. Computed Tomography (CT) Scan examination showed a picture of hydrocephalus.
Conclusion: To date, it has not been proven that pregnancy triggers brain tumors. However, increased blood supply to the brain during pregnancy may lead to tumor growth. This is supported by evidence showing an increase in maternal blood volume and subsequent cerebral blood flow, causing an increase in the size of the SOL. It is also unproven that brain tumors directly harm the fetus, though fetal hypoxia may occur indirectly due to maternal respiratory failure.

Keywords: left hemiparesis; obstructive hydrocephalus; space occupying lesion (SOL); brain tumor; pregnancy; maternal health