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Sylvian cleft meningioma: surgical approach and postoperative morbidity
1Neurosurgical Unit, Department of Surgery, University of Port Harcourt Teaching, Hospital, Port Harcourt, Rivers State, Nigeria. patejakpor@yahoo.com
Background:
Meningiomas without dural attachments are rare, and are commonly diagnosed postoperatively. We here report a case of meningioma and examine the surgical options.
Method:
We reviewed the case record of the patient who presented with a right sylvian cleft meningioma as well as relevant literature on the subject.
Result:
Brain CT scan performed on a 73-year-old woman on admission for non-specific symptoms revealed. a heterodense temporoparietal mass which was demonstrated on carotid angiography as being fed by the middle cerebral artery. Preoperatively, a glioma was considered as being most probable because of its radiological features. The mass, which at surgery was found to be located in the sylvian fissure, was however histologically confirmed to be a meningotheliomatous meningioma with fibroblastic component
Conclusion:
The surgical approach to meningioma of the sylvian cleft is a prime determinant of outcome following tumour resection. Making an appropriate approach largely depends on making a correct preoperative diagnosis for which a high index of suspicion is necessary.
Insights
Meningiomas without dural attachments are rare, but this case highlights a sylvian cleft meningioma. Early diagnosis and appropriate surgical approach are crucial for favorable outcomes in these challenging brain tumors.
Area of Science:
- Neurosurgery
- Neuropathology
- Neuroradiology
Background:
- Meningiomas lacking dural attachments are uncommon, often leading to postoperative diagnoses.
- This report details a rare case of sylvian cleft meningioma and discusses surgical management strategies.
Observation:
- A 73-year-old woman presented with non-specific symptoms, revealing a temporoparietal mass on CT scan.
- Carotid angiography showed the mass was supplied by the middle cerebral artery.
- Radiological features suggested a glioma preoperatively.
Findings:
- Surgical exploration identified the mass within the sylvian fissure.
- Histopathological examination confirmed a meningotheliomatous meningioma with a fibroblastic component.
Implications:
- The surgical approach significantly impacts outcomes for sylvian cleft meningiomas.
- A high index of suspicion is essential for accurate preoperative diagnosis and planning.
