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[A case of atypical meningioma associated with acute deterioration and cerebral herniation]

Kentaro Hayashi1, Hideaki Takahata, Minoru Nakamura

  • 1Department of Neurosurgery, Sasebo City General Hospital. kenkunijp@yahoo.co.jp

No Shinkei Geka. Neurological Surgery
|January 15, 2004
PubMed

Insights

This case report highlights a rare atypical meningioma presenting with sudden, severe symptoms mimicking brain abscess. Prompt surgical intervention was crucial for this brain tumor.

Area of Science:

  • Neurosurgery
  • Neuropathology
  • Neuroradiology

Background:

  • Meningiomas typically present with chronic, insidious symptoms.
  • Sudden onset and rapid progression are unusual presentations for meningiomas.

Observation:

  • A 49-year-old female presented with sudden severe headache, fever, unconsciousness, and left hemiparesis.
  • Emergency imaging revealed a large, right temporal ring-enhancing lesion with significant peritumoral edema.
  • Despite medical management for edema, her condition rapidly deteriorated.

Findings:

  • Histopathology confirmed an atypical meningioma with massive necrosis.
  • The tumor was extra-axial, measuring 5 cm.
  • Radiological features mimicked glioma, and clinical presentation resembled brain abscess.

Implications:

  • This case underscores that meningiomas can present with acute, aggressive neurological conditions.
  • It serves as a critical reminder for neurosurgeons to consider meningioma in the differential diagnosis of ring-enhancing brain masses with rapid symptom progression.
  • Massive peritumoral edema, potentially from an occluded feeder vessel, may explain the atypical presentation.

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