This chapter describes the diagnosis, treatment, and prognosis of intracranial tumors in pregnancy. Common symptoms of increased intracranial pressure, including nausea and vomiting, can potentially be confused with routine pregnancy related conditions such as hyperemesis gravidarum, thereby posing specific diagnostic challenges for physicians. Magnetic resonance imaging (MRI) is probably the diagnostic imaging procedure of choice and should be performed when a brain tumor is suspected and when seizures appear during pregnancy. Computed tomography (CT), however, is the choice of many physicians for an initial neuroimaging test because of its low cost, widespread availability, and relative short procedure duration, and is considered safe during pregnancy. Surgery and radiotherapy are the main therapeutic procedures. Bromocriptine has been shown to be safe and remains the drug of choice during pregnancy, but should only be used for symptomatic treatment.

The frequency of epilepsy in certain conditions is well known, for example, de novo epilepsy after operative treatment of intracranial abscess is around 70% but this would probably occur independent of the surgical technique used. It seems that craniotomy probably increases the liability of de novo epilepsy by 5-10%. The complexity of the procedure also increases the incidence. Studies of post-traumatic epilepsy with modern imaging techniques have shown the relationship between cortical damage, in particular cortical contusions and post-traumatic epilepsy. The literature on cerebral tumors suggests that late postoperative seizures are more likely to be partial seizures and may be more difficult to control. Antiepileptic drugs (AEDs) are known to be metabolized along established pathways that they may share with other AEDs and also with non-anticonvulsant drugs. Other treatments such as further surgery and adjuvant therapy for intracranial tumors may be useful in treating difficult de novo seizures.