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Spontaneous infarction within a meningioma with negative DWI: an imaging pattern in patients with acute neurological

J Hall1, Y Y Wang1,2, P Smith1

  • 1Department of Neurosurgery, St Vincent's Hospital, Melbourne, VIC, Australia.

BJR Case Reports
|October 27, 2018
PubMed

Insights

Meningiomas, slow-growing brain tumors, can cause rapid neurological decline due to increased intracranial pressure (ICP). This study highlights spontaneous tumor infarction and associated swelling as a cause of acute ICP rise and deterioration.

Area of Science:

  • Neuro-oncology
  • Neurosurgery
  • Neuropathology

Background:

  • Meningiomas are typically slow-growing tumors.
  • Patients can experience sudden neurological deterioration due to increased intracranial pressure (ICP).
  • Peritumoral edema is a common cause of raised ICP, but its mechanism is not fully understood.

Observation:

  • Two cases of spontaneous meningioma infarction are presented.
  • Meningioma infarction led to the development of peritumoral edema.
  • This combination resulted in increased ICP and acute neurological deterioration.

Findings:

  • Spontaneous infarction of meningiomas can precipitate significant peritumoral edema.
  • The infarction-edema complex can rapidly elevate intracranial pressure.
  • This pathological cascade leads to acute neurological decline in patients with meningioma.

Implications:

  • Highlights a rare but critical mechanism for rapid neurological deterioration in meningioma patients.
  • Suggests monitoring for edema in cases of suspected meningioma infarction.
  • Informing diagnostic and management strategies for meningioma complications.

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