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Grade III en-plaque meningioma mimicking subacute subdural hematoma: A case report

Novan Krisno Adji1, Komang Yunita Wiryaning Putri2, Laksmi Indreswari3

  • 1Department of Neurosurgery, Faculty of Medicine, University of Jember/dr. Soebandi Regional Hospital, Jember, Indonesia.

International Journal of Surgery Case Reports
|July 3, 2024
PubMed
Abstract

Insights

En-plaque meningioma (EPM) can mimic other brain conditions, posing diagnostic challenges. This case highlights how a fall history and imaging resembling subacute subdural hematoma can lead to misdiagnosis, impacting patient management.

Area of Science:

  • Neurosurgery
  • Neuropathology
  • Radiology

Background:

  • En-plaque meningioma (EPM) presents diagnostic challenges due to atypical radiologic features.
  • Accurate preoperative diagnosis is crucial for effective surgical management of EPM.

Observation:

  • A 58-year-old female with altered consciousness, headache, nausea, and vomiting.
  • CT scan revealed a temporoparietal mass initially misdiagnosed as subacute subdural hematoma (saSDH).
  • Intraoperative findings identified an extradural intracranial tumor, confirmed as anaplastic meningioma (WHO grade III) post-histopathology.

Findings:

  • EPM's variable appearance can obscure preoperative diagnosis.
  • Patient history of head trauma and CT findings mimicking saSDH complicated the initial diagnosis.
  • The misdiagnosis led to a change in surgical approach from burr hole evacuation to tumor excision craniotomy.

Implications:

  • Meticulous preoperative evaluation is essential for distinguishing EPM from other intracranial pathologies.
  • Early and accurate diagnosis of EPM improves surgical planning and patient outcomes.
  • This case underscores the importance of considering rare diagnoses despite seemingly common presentations.
Keywords:
Case reportEn-plaque meningiomaNeurosurgerySubacute subdural hematoma

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