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A case of benign meningioma presented with subdural hemorrhage

Joo-Hwan Kim1, Ho-Shin Gwak1, Eun Kyung Hong2

  • 1Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea.

Brain Tumor Research and Treatment
|May 16, 2015
PubMed

Insights

This case study highlights a rare instance of a benign meningioma presenting as a subdural hemorrhage after coughing. It emphasizes the uncommon occurrence of hemorrhage in these common brain tumors.

Area of Science:

  • Neurology
  • Neurosurgery
  • Oncology

Background:

  • Meningiomas are the most frequent benign intracranial tumors, accounting for 13-26% of all primary brain tumors.
  • Hemorrhage is a rare clinical presentation of meningiomas, occurring in approximately 1.3% of cases, with subdural hemorrhages being even less common.
  • The exact mechanisms leading to hemorrhage in meningiomas remain unclear and may be influenced by histologic type, tumor location, and hemorrhage characteristics.

Purpose of the Study:

  • To report and discuss a rare case of a conventional meningioma (World Health Organization grade I) presenting as a subdural hemorrhage.
  • To explore the potential mechanisms and clinical implications of subdural hemorrhage in the context of meningioma.

Main Methods:

  • Case report of a 61-year-old woman with a sudden onset of headache following aggressive coughing.
  • Clinical evaluation including imaging studies (CT/MRI) revealing a right frontal hemorrhagic subdural mass lesion with an ipsilateral subdural hematoma.
  • Surgical intervention and histopathological examination confirming a conventional meningioma (WHO grade I).

Main Results:

  • The patient presented with headache as the sole symptom, attributed to a right frontal hemorrhagic subdural mass lesion.
  • Intraoperative findings and permanent pathology confirmed a conventional meningioma (WHO grade I) associated with a mixed-stage diffuse subdural hematoma.
  • The event occurred subsequent to aggressive coughing, suggesting a possible precipitating factor for the hemorrhage.

Conclusions:

  • This case underscores the rare but possible presentation of meningiomas as subdural hemorrhages, even in benign (WHO grade I) tumors.
  • The study contributes to the understanding of rare meningioma complications and the importance of considering them in the differential diagnosis of spontaneous intracranial hemorrhages.
  • Further research into the specific mechanisms of hemorrhage in meningiomas is warranted to improve diagnostic and therapeutic strategies.
Keywords:
Benign neoplasmHematoma, subduralHemorrhageMeningioma

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