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[A case of deep sylvian meningioma with intracerebral hematoma (author's transl)]
Abstract:
A case of deep sylvian meningioma is reported which is unusual in the aspect that the initial symptoms were headache and vomiting due to intracerebral hemorrhage from meningioma. After evacuation of hematoma in the right temporal lobe and biopsy of the tumor, it was found to be meningothelial meningioma with psammoma bodies. Cerebral angiography showed characteristic findings of intrasylvian vascular tumor. Complete removal of this tumor was performed under microscopy, dissecting dense adhesion between the tumor and main branches of the middle cerebral artery. Consequently, the patient showed only slight impairment of fine movement of his left fingers. Deep sylvian meningioma designated by Cushing and Eisenhart is very rare. This case is the only one of deep sylvian meningioma in our whole series of 181 intracranial meningiomas and probably the twentieth case reported so far in the literature.
Insights
A rare deep sylvian meningioma presented with intracerebral hemorrhage, causing initial symptoms of headache and vomiting. Surgical removal was successful, with minimal neurological deficit, highlighting a unique case presentation and management.
Area of Science:
- Neurosurgery
- Neuropathology
- Neuroradiology
Background:
- Deep sylvian meningiomas are exceptionally rare intracranial tumors.
- Intracerebral hemorrhage as an initial presentation of meningioma is uncommon.
Observation:
- A case of deep sylvian meningioma is presented with initial symptoms of headache and vomiting due to intracerebral hemorrhage.
- The tumor was identified as a meningothelial meningioma with psammoma bodies.
- Cerebral angiography revealed characteristic findings of an intrasylvian vascular tumor.
Findings:
- Complete surgical resection of the deep sylvian meningioma was achieved using microsurgical techniques.
- The tumor exhibited dense adhesions to the middle cerebral artery branches.
- The patient experienced only minor impairment of fine motor function in the left hand post-surgery.
Implications:
- This case underscores the importance of considering meningioma in the differential diagnosis of spontaneous intracerebral hemorrhage.
- Successful microsurgical removal of deeply located meningiomas is feasible, even with significant vascular adhesions.
- Reporting rare cases like this contributes valuable data to the limited literature on deep sylvian meningiomas.