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[Complications during preoperative embolization in intracranial meningioma]
L Beretta1, A Dell'Acqua, E Giorgi
1Servizio di Anestesia e Rianimazione, Istituto Scientifico H San Raffaele, Milano.
Abstract:
We report a rare case of meningioma of the parieto-occipital convexity accompanied by hemorrhage in the tumor and in the subdural space that occurred while pre-operative embolization was being applied. The patient, a 48 year old woman, presented sudden headache and, in a few minutes, comatose status and decerebrate rigidity. A quick diagnosis with CT-scan of acute intratumoral and subdural hemorrhage and a rapid intervention on the patient led to complete recovery. The possible reason for the hemorrhage is the sudden change in blood pressure of pathologic small vessels triggered by embolization.
Insights
A rare brain tumor complication occurred during embolization. Meningioma hemorrhage led to sudden coma but rapid intervention ensured complete recovery.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Meningiomas are tumors arising from the meninges.
- Pre-operative embolization is a common procedure to reduce blood flow to tumors before surgical removal.
Observation:
- A 48-year-old woman experienced sudden headache, progressing to coma and decerebrate rigidity.
- The patient had a parieto-occipital convexity meningioma with intratumoral and subdural hemorrhage.
Findings:
- Hemorrhage occurred during pre-operative embolization, a rare complication.
- CT-scan confirmed acute intratumoral and subdural hemorrhage.
- Rapid diagnosis and intervention led to complete patient recovery.
Implications:
- Embolization may trigger sudden blood pressure changes, leading to hemorrhage in specific tumor vessels.
- This case highlights the importance of prompt diagnosis and intervention for managing rare neurosurgical complications.
- Further research into the vascular fragility of meningiomas during embolization may be warranted.