Multifocal cerebral cavernous malformations in pregnancy:  a rare neuro-obstetric case

Saizal Jain; Himanshi Pareek; Simmanjit Kaur; Vaishnavi Verma; Apoorva Raghuvanshi; Amaneet Kaur

doi:10.18203/2320-1770.ijrcog20262143

Authors

Saizal Jain Department of Obstetrics and Gynaecology, MMIMSR, Mullana, Ambala, Haryana, India
Himanshi Pareek Department of Obstetrics and Gynaecology, MMIMSR, Mullana, Ambala, Haryana, India
Simmanjit Kaur Department of Obstetrics and Gynaecology, MMIMSR, Mullana, Ambala, Haryana, India
Vaishnavi Verma Department of Obstetrics and Gynaecology, MMIMSR, Mullana, Ambala, Haryana, India
Apoorva Raghuvanshi Department of Radiodiagnosis, M. M. Institute of Medical Sciences and Research (MMIMSR), Mullana, Haryana, India
Amaneet Kaur Department of Obstetrics and Gynaecology, MMIMSR, Mullana, Ambala, Haryana, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20262143

Keywords:

Cerebral cavernous malformation, Seizures, Neuro-obstetrics, Caesarean section

Abstract

Cerebral cavernous malformations (CCMs) are rare vascular lesions characterised by clusters of dilated capillaries that may present with seizures or intracranial haemorrhage. Their coexistence with pregnancy poses diagnostic and management challenges. We report a 30-year-old G2P1L1 woman at 37 weeks gestation with a history of generalized tonic-clonic seizures (GTCS) and multifocal CCMs. She had no seizures during the antenatal period. Magnetic resonance imaging (MRI) revealed multiple cavernomas with evidence of prior haemorrhage. A multidisciplinary team opted for elective caesarean section, resulting in successful maternal and foetal outcomes.

Metrics

Metrics Loading ...

References

Mouchtouris N, Chalouhi N, Chitale A, Starke RM, Tjoumakaris SI, Rosenwasser RH, et al. Management of cerebral cavernous malformations: from diagnosis to treatment. Sci World J. 2015;2015:808314. DOI: https://doi.org/10.1155/2015/808314

Flemming KD, Lanzino G, Brown RD. Natural history of cerebral cavernous malformations. Stroke. 2017;48(3):551-9.

Gross BA, Du R. Imaging features and clinical characteristics of cerebral cavernous malformations. World Neurosurg. 2017;98:497-503.

Al-Shahi Salman R, Hall JM, Horne MA, Moultrie F, Josephson CB, Bhattacharya JJ, et al. Untreated clinical course of cerebral cavernous malformations: a prospective population-based cohort study. Lancet Neurol. 2018;17(3):217-24. DOI: https://doi.org/10.1016/S1474-4422(12)70004-2

Hongo H, Miyawaki S, Teranishi Y. Genetics of brain arteriovenous malformations and cerebral cavernous malformations. J Hum Genet. 2023;68(3):157-67. DOI: https://doi.org/10.1038/s10038-022-01063-8

Taslimi S, Modabbernia A, Amin-Hanjani S, Barker FG 2nd, Macdonald RL. Natural history of cavernous malformation: systematic review and meta-analysis of hemorrhage and seizure risk. Neurology. 2016;86(21):1984-91. DOI: https://doi.org/10.1212/WNL.0000000000002701

Aydin HA, Keskin E, Kalayci M. Management of cerebral cavernous malformations during pregnancy: a systematic review and case illustration. Egypt J Neurol Psychiatry Neurosurg. 2026;62(1):3. DOI: https://doi.org/10.1186/s41983-026-01066-8

Merlino L, De Bonis P, Tamburrini G, Pompucci A, Anile C. Cerebral cavernous malformations during pregnancy and puerperium: management and outcomes. J Gynecol Obstet Hum Reprod. 2021;50(8):102118.

Tasiou A, Brotis AG, Kalogeras A. Cavernous malformations of the central nervous system: An international consensus statement. Brain Spine. 2023;3:102707. DOI: https://doi.org/10.1016/j.bas.2023.102707

Merlino L, Del Prete F, Titi L, Piccioni MG. Cerebral cavernous malformation: Management and outcome during pregnancy and puerperium. A systematic review of literature. J Gynecol Obstet Hum Reprod. 2021;50(1):101927. DOI: https://doi.org/10.1016/j.jogoh.2020.101927

Merlino L, De Bonis P, Tamburrini G, Pompucci A, Anile C, et al. Pregnancy outcomes in women with cerebral cavernous malformations. J Gynecol Obstet Hum Reprod. 2021;50(8):102118.