Peripartum Anesthetic Management of a Parturient with Brain Metastases and Herniation Undergoing Sitting Craniotomy and Subsequent Cesarean Section

A BSTRACT Parturients with brain tumors present the unique picture of dealing with the pathology of intracranial hypertension and the physiologic and ethical considerations of having a viable fetus. This case report discusses the peripartum anesthetic management of a 31-year-old parturient with a recurrent metastatic parieto-occipital brain tumor causing subfalcine herniation. She underwent a craniotomy in the semi-sitting position at 27-week gestation, followed by a cesarean section at 31 weeks. The anesthetic management done in this case emphasizes the need for an individualized, multidisciplinary approach that addresses the maternal disease, pregnancy physiology, and patient autonomy to ensure optimal feto-maternal outcomes.