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Management of Tiny Meningiomas: To Resect or Not Resect
Julia R Schneider1, Kay O Kulason1, Tim White2
1Neurosurgery, Brain Tumor Center, Lenox Hill Hospital, Hofstra Northwell School of Medicine.
Abstract:
Meningiomas are most often benign primary intracranial tumors that are frequently found incidentally on imaging. Larger sized meningiomas may present with symptoms such as seizures and headaches. Smaller meningiomas are commonly asymptomatic and usually observed with serial imaging. We present two female patients, both of whom were found to have very small left frontal meningiomas that marginated Broca's area. The first patient in this case series experienced episodes resembling seizures which consisted of weakness, vision loss, and slurred speech, as well as subtle language dysfunction in her day-to-day conversations. The second patient presented with headaches and an enlarging meningioma. Both meningiomas were surgically resected and the patients' symptoms resolved. Small meningiomas should not be overlooked as they may very well be the source of neurologic symptoms.
Insights
Small meningiomas, often asymptomatic, can cause significant neurologic symptoms like seizures and headaches. These benign brain tumors, even when small, warrant careful evaluation and should not be overlooked.
Area of Science:
- Neurology
- Neurosurgery
- Oncology
Background:
- Meningiomas are typically benign primary intracranial tumors, often discovered incidentally during imaging studies.
- While larger meningiomas frequently cause symptoms like seizures and headaches, smaller ones are commonly asymptomatic and monitored with serial imaging.
Observation:
- This case series details two female patients with very small left frontal meningiomas adjacent to Broca's area.
- The first patient experienced seizure-like episodes including weakness, vision loss, slurred speech, and subtle language deficits.
- The second patient presented with headaches and a growing meningioma.
Findings:
- Both patients underwent surgical resection of their small meningiomas.
- Post-surgery, both patients experienced complete resolution of their presenting neurologic symptoms.
Implications:
- This study highlights that small meningiomas, even those near critical brain areas like Broca's, can manifest with distinct neurologic symptoms.
- It underscores the importance of considering small meningiomas as a potential cause of neurological deficits, even when asymptomatic or incidentally found.
