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Published on: June 18, 2021
Spontaneous Intracranial Hemorrhage Associated With an Intracranial Meningioma
Bill R Ferrufino-Mejia1,2, Héctor A Rodríguez-Rubio1, Rodrigo López-Rodríguez1
1Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, MEX.
Abstract:
Spontaneous intracranial hemorrhage associated with an intracranial meningioma is rare, with a reported incidence of below 2.4% of all meningiomas. Such cases are described with a cause subdural with intratumoral hemorrhage, which is a challenge for patients and healthcare professionals because it can occur spontaneously without other pathological antecedents. We describe the case of a 55-year-old woman with subdural hemorrhage over the frontoparietal region of the right hemisphere associated with a meningioma, generating a mass effect and shifting the third ventricle and lateral ventricle. Therefore, urgent surgical treatment was decided. A tumor lesion was found with apoplexy, soft consistency, and violaceous color with abundant vascularity in the lesion's center, suggesting a probable angiomatous meningioma. The histopathological evaluation confirmed meningothelial hemorrhagic meningioma grade I, according to the World Health Organization grading. This article discusses the causes, risk factors, diagnosis, and surgical treatment for hemorrhage associated with intracranial meningioma.
Insights
Spontaneous intracranial hemorrhage linked to meningioma is rare. This case highlights urgent surgical intervention for a hemorrhagic meningioma presenting with subdural bleeding.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- Spontaneous intracranial hemorrhage (SIH) associated with intracranial meningioma is a rare occurrence, with an incidence below 2.4% of all meningiomas.
- These events can present as subdural or intratumoral hemorrhage, posing diagnostic and therapeutic challenges due to their spontaneous nature.
Observation:
- A 55-year-old woman presented with spontaneous subdural hemorrhage in the right frontoparietal region.
- The hemorrhage was associated with an intracranial meningioma causing significant mass effect and ventricular displacement.
- Intraoperative findings revealed a hemorrhagic tumor with soft consistency and abundant vascularity, suggestive of an angiomatous meningioma.
Findings:
- Histopathological evaluation confirmed a World Health Organization (WHO) Grade I meningothelial hemorrhagic meningioma.
- The tumor exhibited apoplexy, characterized by sudden bleeding within the tumor and surrounding structures.
Implications:
- This case underscores the importance of considering meningioma in the differential diagnosis of spontaneous intracranial hemorrhage.
- Prompt surgical management is crucial for patients presenting with hemorrhagic meningioma to alleviate mass effect and prevent further complications.
- Further research into risk factors and optimal treatment strategies for hemorrhagic meningiomas is warranted.
