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[Ipsilateral coexistence of AVM and meningioma: a case report]
Abstract:
The authors encountered a rare case of sphenoidal ridge meningioma associated with an arteriovenous malformation in the same cerebral hemisphere. A 65-year-old female was admitted to our service because of headache. X-ray computed tomography (X-CT) and magnetic resonance image (MRI) disclosed a huge mass with peripheral edema, diagnosed as a sphenoidal ridge meningioma. An associated small mass was also noted in the right parahippocampal gyrus. This was confirmed by angiography as an arteriovenous malformation (AVM). During the waiting period for surgical treatment she had fallen into coma abruptly. Emergency X-CT revealed intracerebral and intraventricular hematomas. Both lesions were resected successfully in a one stage operation. Postoperative course was uneventful. In general, AVM located in the medial temporal lobe is difficult to approach. However, in this case, the resultant large cavity obtained after removal of meningioma afforded us easy access to the AVM.
Insights
This study reports a rare case of sphenoidal ridge meningioma co-occurring with an arteriovenous malformation (AVM). Surgical resection of both brain lesions was successful, with the meningioma cavity facilitating AVM access.
Area of Science:
- Neurosurgery
- Neuroradiology
- Neuropathology
Background:
- Sphenoidal ridge meningiomas are common intracranial tumors.
- Arteriovenous malformations (AVMs) are congenital vascular anomalies.
- Co-occurrence of meningioma and AVM in the same hemisphere is exceptionally rare.
Observation:
- A 65-year-old female presented with headache.
- Imaging revealed a large sphenoidal ridge meningioma with edema and a concurrent right parahippocampal arteriovenous malformation.
- The patient acutely developed intracerebral and intraventricular hematomas.
Findings:
- Diagnostic imaging, including X-ray computed tomography (X-CT) and magnetic resonance imaging (MRI), confirmed the sphenoidal ridge meningioma and arteriovenous malformation.
- Angiography further characterized the vascular nature of the AVM.
- A successful one-stage surgical resection of both the meningioma and the AVM was performed.
Implications:
- This case highlights the importance of thorough vascular assessment in patients with complex intracranial masses.
- The surgical strategy demonstrated that a meningioma cavity can provide advantageous access to adjacent or associated vascular malformations.
- Successful management of this rare combined pathology underscores advancements in neurosurgical techniques and multimodal imaging.