Traumatic Diaphragmatic Rupture

Meningiomas have been found to have receptors for progestational hormones and growth may increase durinl pregnancy or with the use of hormonal contraceptives)' . Mengiomas may therefore become symptomatic with fits in late pregnancy when the level of these hormones is high. Early diagnosis offers the best prospect for complete excision of an intracranial meningioma and poor outcome is associated with poor preoperative clinical condition/. The diagnosis in our patient was delayed until recurrent fits and hemiparesis occurred. Seizures from eclampsia are usually generalized and rarely focal in onset. Eclampsia persisting up to 48 hours postpartum is unusual and other causes of seizures should be considered. The differential diagnosis of seizures around pregnancy would include intracranial tumours. cerebrovascular accident. amniotic fluid embolism and sagittal sinus thrombosis. In environments such as ours. meningitis may also cause seizures during pregnancy. A high index of suspicion is vital for the diagnosis of a meningioma presenting during pregnancy. Close follow up of eclamptic patients should be undertaken. to identify those with recurrent fits or neurological deficits. Further evaluation. including a brain computerized tomography scan may then be necessary to exclude an intracranial meningioma. Following diagnosis. the meningioma should be promptly treated.