Welcome to Open Science
Contact Us
Home Books Journals Submission Open Science Join Us News
A Missed Diagnosis of Cerebellar Astrocytoma During Pregnancy
Current Issue
Volume 2, 2015
Issue 4 (August)
Pages: 48-51   |   Vol. 2, No. 4, August 2015   |   Follow on         
Paper in PDF Downloads: 26   Since Aug. 28, 2015 Views: 1992   Since Aug. 28, 2015
Elmas Shaqiri, Institute of Legal Medicine, Tirana, Albania.
Bledar Xhemali, Institute of Legal Medicine, Tirana, Albania.
Fatos Harito, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania.
Gentian Vyshka, Faculty of Medicine, University of Medicine in Tirana, Tirana, Albania.
Sudden death due to intracranial tumours is an extreme rarity; nevertheless casuistics is offering continuously cases for consideration. It might overcome within a previously known neoplastic disorder, but it might even be the ever first clinical occurrence, with fatal outcome. Authors present the case of a pregnant woman emergently hospitalized during the 22nd week of her second pregnancy. Symptoms of headache, vomiting and gait instability were misinterpreted as complications of pregnancy. The patient fell in coma few hours after admission and was pronounced dead the next morning. A forensic autopsy revealed the presence of a fibrillary astrocytoma of the left cerebellar hemisphere, leading to diffuse brain swelling and incarceration of nervous structures in the foramen magnum. The necessity of specialized and multi-disciplinary approach and the availability of radiological techniques of brain imaging are formulated, in order to avoid the occurrence of sudden death due to undiagnosed brain tumours, whose incidence is globally decreasing.
Pregnancy, Intracranial Tumours, Hyperemesis Gravidarum, Sudden Death, Astrocytoma
Albright AL, Price RA, Guthkelch AN. Brain stem gliomas of children. A clinicopathological study. Cancer. 1983 Dec 15; 52(12):2313-9.
Burger PC. Pathology of brain stem astrocytomas. Pediatr Neurosurg. 1996; 24(1):35-40.
Fisher PG, Breiter SN, Carson BS, Wharam MD, Williams JA, Weingart JD, Foer DR, Goldthwaite PT, Tihan T, Burger PC. A clinicopathologic reappraisal of brain stem tumor classification. Identification of pilocystic astrocytoma and fibrillary astrocytoma as distinct entities. Cancer. 2000 Oct 1; 89(7):1569-76.
Burger PC, Cohen KJ, Rosenblum MK, Tihan T. Pathology of diencephalic astrocytomas. Pediatr Neurosurg. 2000 Apr; 32(4):214-9.
Opeskin K, Ruszkiewicz A, Anderson RM. Sudden death due to undiagnosed medullary-pontine astrocytoma. Am J Forensic Med Pathol. 1995 Jun; 16(2):168-71.
Vyshka G, Shaqiri E, Ymaj B. Sudden death due to medulloblastoma. BMJ Case Rep. 2010; 2010. Pii: bcr10.2009.2378. Doi: 10.1136/bcr.10.2009.2378.
Wegrzyniak LJ, Repke JT, Ural SH. Treatment of hyperemesis gravidarum. Rev Obstet Gynecol. 2012; 5(2):78-84.
Riezzo I, Zamparese R, Neri M, De Stefano F, Parente R, Pomara C, Turillazzi E, Ventura F, Fineschi V. Sudden, unexpected death due to glioblastoma: report of three fatal cases and review of the literature. Diagn Pathol. 2013 May 2; 8:73.
Manousaki M, Papadaki H, Papavdi A, Kranioti EF, Mylonakis P, Varakis J, Michalodimitrakis M. Sudden unexpected death from oligodendroglioma: a case report and review of the literature. Am J Forensic Med Pathol. 2011 Dec; 32(4):336-40.
Michelsen JJ, New PF. Brain tumour and pregnancy. J Neurol Neurosurg Psychiatry. 1969 Aug; 32(4):305-7.
Lynch JC, Gouvêa F, Emmerich JC, Kokinovrachos G, Pereira C, Welling L, Kislanov S. Management strategy for brain tumour diagnosed during pregnancy. Br J Neurosurg. 2011 Apr; 25(2):225-30.
Yust-Katz S, de Groot JF, Liu D, Wu J, Yuan Y, Anderson MD, Conrad CA, Milbourne A, Gilbert MR, Armstrong TS. Pregnancy and glial brain tumors. Neuro Oncol. 2014 Sep; 16(9):1289-94.
Goma HM. Management of brain tumor in pregnancy – an anesthesia window. Chapter 24. In: Lichtor T. (Ed): Clinical management and evolving novel therapeutic strategies for patients with brain tumors. Publisher: InTech. 2013; pp. 555-568. Doi: 10.5772/54250.
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007 Aug; 114(2):97-109.
Pant I, Chaturvedi S, Jha DK, Kumari R, Parteki S. Central nervous system tumors: Radiologic pathologic correlation and diagnostic approach. J Neurosci Rural Pract. 2015 Apr-Jun; 6(2):191-7.
Eren B, Türkmen N, Comunoglu N, Oz B, Senel B, Eren F. Sudden death due to a rare brain tumor: an autopsy case. Soud Lek. 2012 Oct; 57(4):60-1.
Eberhart CG, Morrison A, Gyure KA, Frazier J, Smialek JE, Troncoso JC. Decreasing incidence of sudden death due to undiagnosed primary central nervous system tumors. Arch Pathol Lab Med. 2001 Aug; 125(8):1024-30.
Bara P, Gjyli L, Gega M, Belshi X, Vyshka G. Aortic pathologies and pregnancy: a special focus on connective tissue disorders. Cardiol Angiol. 2014; 2(3): 147-153. Doi: 10.9734/CA/2014/10425.
Pope JV, Edlow JA. Avoiding misdiagnosis in patients with neurological emergencies. Emerg Med Int. 2012; 2012:949275. Doi: 10.1155/2012/949275.
Isla A, Alvarez F, Gonzalez A, García-Grande A, Perez-Alvarez M, García-Blazquez M. Brain tumor and pregnancy. Obstet Gynecol. 1997 Jan; 89(1):19-23.
Verheecke M, Halaska MJ, Lok CA, Ottevanger PB, Fruscio R, Dahl-Steffensen K, Kolawa W, Gziri MM, Han SN, Van Calsteren K, Van den Heuvel F, De Vleeschouwer S, Clement PM, Menten J, Amant F; ESGO Task Force ‘Cancer in Pregnancy’. Primary brain tumours, meningiomas and brain metastases in pregnancy: report on 27 cases and review of literature. Eur J Cancer. 2014 May; 50(8):1462-71.
Open Science Scholarly Journals
Open Science is a peer-reviewed platform, the journals of which cover a wide range of academic disciplines and serve the world's research and scholarly communities. Upon acceptance, Open Science Journals will be immediately and permanently free for everyone to read and download.
Office Address:
228 Park Ave., S#45956, New York, NY 10003
Phone: +(001)(347)535 0661
Copyright © 2013-, Open Science Publishers - All Rights Reserved