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Acute haemorrhage into a microcystic meningioma leading to cerebral herniation

O W Sakowitz1, I Harting, P Kohlhof

  • 1Department of Neurosurgery, University of Heidelberg, Germany. oliver.sakowitz@med.uni-heidelberg.de

British Journal of Neurosurgery
|February 4, 2006
PubMed

Insights

A rare case of intratumoural haemorrhage (ITH) in a low-grade meningioma caused tentorial herniation. Emergency surgery led to a positive outcome, highlighting a rare complication of benign brain tumors.

Area of Science:

  • Neurology
  • Neurosurgery
  • Oncology

Background:

  • Low-grade (WHO level I) meningiomas are typically benign and slow-growing brain tumors.
  • Common symptoms include headaches, seizures, and cranial nerve compression, varying with tumor size and location.
  • Intratumoural haemorrhage (ITH) is an infrequent complication of meningiomas, particularly low-grade ones.

Observation:

  • A 50-year-old male presented with signs of tentorial herniation due to acute ITH in an undiagnosed meningioma.
  • The patient experienced a hyperacute onset of symptoms.
  • Emergency surgical decompression and tumor removal were performed.

Findings:

  • The case highlights a rare instance of ITH in a low-grade meningioma leading to life-threatening tentorial herniation.
  • Factors contributing to hemorrhage risk in meningiomas are discussed.
  • Despite the rarity, ITH is a potential complication across all intracranial neoplasms, including benign types.

Implications:

  • This case underscores the importance of recognizing ITH as a rare but severe complication of meningiomas.
  • Physicians and patients with known meningiomas should be aware of this potential, even with conservative management.
  • Prompt surgical intervention is crucial for favorable outcomes in cases of symptomatic ITH with herniation.

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