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Meningiomas Associated with Subdural Hematomas: A Systematic Review of Clinical Features and Outcomes
Abdelsimar T Omar1, Yves P Starreveld1
1Division of Neurosurgery, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Background:
Meningiomas associated with subdural hematomas (SDHs) are exceedingly rare. As such, the clinical features, optimal medical and surgical management, and outcomes of treatment for these lesions remain unknown.
Methods:
We performed a systematic review of the PubMed and Scopus databases for case reports and case series of patients with presumptive clinical or definitive diagnoses of meningiomas presenting with SDH on computed tomography scan or magnetic resonance imaging. Data on demographics, clinical manifestations, surgical management, adjuvant treatment, and outcome on last follow-up were collected.
Results:
Inclusion criteria were met by 59 cases, including a case described in the current study. Mean age of patients was 62 years (range: 5-85 years), with a slight female predilection (1.3:1). The most common clinical symptom and sign were headache and focal weakness, respectively. All except 2 patients underwent surgery, either a single or staged procedure, for evacuation of hematoma and/or excision of tumor. Treatment for meningioma in patients who presented with SDH was associated with a mortality rate of 12% (6/51) at a median follow-up of 3 months. Complete neurologic recovery was reported in 71% of patients.
Conclusions:
SDHs are rare manifestations of intracranial meningiomas. Current management is largely surgical for immediate relief of mass effect and oncologic control. Most reported patients survived with complete neurologic recovery.
Insights
Meningiomas rarely cause subdural hematomas (SDHs). Surgical management is key for these rare intracranial tumors, with most patients experiencing complete neurologic recovery after treatment.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Neurology
Background:
- Meningiomas associated with subdural hematomas (SDHs) are exceptionally rare.
- Limited understanding exists regarding the clinical presentation, management, and outcomes for these specific cases.
Purpose of the Study:
- To systematically review and synthesize existing literature on meningiomas presenting with SDH.
- To elucidate the clinical features, treatment strategies, and patient outcomes.
Main Methods:
- A systematic review of PubMed and Scopus databases was conducted.
- Case reports and series of patients with meningioma and SDH were analyzed.
- Data collected included demographics, clinical symptoms, surgical interventions, and follow-up outcomes.
Main Results:
- Fifty-nine cases were included, with a mean patient age of 62 years and a slight female predominance.
- Headache and focal weakness were the most frequent symptoms and signs.
- Surgery was performed in most patients, with a 12% mortality rate and 71% complete neurologic recovery.
Conclusions:
- Subdural hematomas are uncommon presentations of intracranial meningiomas.
- Surgical intervention is the primary management approach for both mass effect relief and tumor control.
- The majority of patients treated for meningioma-associated SDH achieve complete neurologic recovery.
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