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Parasagittal meningioma: A not so benign entity
1School of Medicine, The University of Adelaide, Australia.
Medicine, Science, and the Law
|September 21, 2017
Summary
Sudden death can rarely occur from large, slow-growing intracranial meningiomas. These cases highlight rapid deterioration and fatal outcomes in patients with parasagittal meningiomas, emphasizing the need for prompt diagnosis.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- Intracranial meningiomas are typically slow-growing tumors.
- While often benign, rare instances of sudden, fatal outcomes are documented.
Observation:
- Two cases of sudden death in patients with large, grade I, parasagittal meningiomas are presented.
- Case 1: A 46-year-old male with a history of seizures experienced sudden collapse and death due to a hemorrhaged meningioma causing brain compression and herniation.
- Case 2: An 83-year-old female presented with progressive dysphagia and dysphasia, rapidly deteriorating to death, attributed to a parasagittal meningioma compressing frontal lobes.
Findings:
- Large parasagittal meningiomas, despite being WHO grade I, can lead to rapid clinical deterioration and death.
- Hemorrhage and significant mass effect causing brain herniation were key factors in the fatal outcomes.
- Neurological deficits such as dysphagia and dysphasia can be presenting symptoms.
Implications:
- Autopsy findings of meningiomas should prompt consideration of lethal effects and screening for associated genetic conditions like neurofibromatosis type 2.
- Clinicians should be aware of the potential for rapid deterioration in patients with large meningiomas, even those initially appearing indolent.
- Early detection and management of intracranial meningiomas are crucial to prevent catastrophic neurological events.
