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ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Progressive Nausea and Vomiting in Pregnancy: Eliminate Neurological Causes-A Case Report

Rosalie SC Linssen1*, Annelies Verdonkschot2, Jelle de Kruijk3 and W Peter Vandertop4

1Academic Medical Center/University of Amsterdam, The Netherlands

2Department of Gynaecology and Obstetrics, Tergooi Ziekenhuizen, The Netherlands

3Department of Neurology, Tergooi Ziekenhuizen, The Netherlands

4Department of Neurosurgery, Academic Medical Center and VU University Medical Center, Amsterdam, The Netherlands

*Corresponding Author:
Rosalie SC Linssen
Academic Medical Center/ University of Amsterdam
The Netherlands
Tel: +31 20 556 3316
E-mail: [email protected]

Received Date: December 17, 2016; Accepted Date: January 23, 2017; Published Date: January 28, 2017

Citation: Linssen RSC, Verdonkschot A, Kruijk J, Vandertop WP (2017) Progressive Nausea and Vomiting in Pregnancy: Eliminate Neurological Causes-A Case Report. J Clin Case Rep 7:917. doi: 10.4172/2165-7920.1000917

Copyright: © 2017 Linssen RSC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Severe nausea and vomiting in the first and second trimester of pregnancy is often diagnosed as hyperemesis gravidarum (HG), although true HG only appears in very few pregnancies. Anchoring, the tendency for clinicians to stick with an initial diagnosis even as new information becomes available, can lead to hesitation to perform MR-imaging in pregnant patients. As prompt diagnosis of intracranial neoplasm increases the chance on a favourable outcome, awareness among doctors is needed. Scant data on pregnant patients diagnosed with brain tumours is available; this case report pays attention to possible pitfalls for doctor’s delay.

Case summary: A 36-year-old G2PO presented with severe nausea, vomiting and vertigo in the first and second trimester of pregnancy after IVF-treatment. An increase of symptoms, headaches and a lurched walking pattern were initially attributed to dehydration, orthostatic hypotension and later to a proven B12 deficiency. When symptoms worsened despite vitamin suppletion and drowsiness and bradyphrenia developed, a MR-scan of the brain showed severe obstructive hydrocephalus caused by a mass in the fourth ventricle. Surgical resection of a ganglioglioma (WHO grade I) was performed at a gestational age of 25 weeks.

Conclusion: HG typically resolves around the 20th week of gestation, therefore persistent nausea and vomiting during pregnancy warrants a cerebral MR-scan in order to exclude neurological causes.

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