[A case of multiple intracranial meningiomas]

Area of Science:

• Neurosurgery
• Neurology
• Oncology

Background:

• Meningiomas are primary tumors of the central nervous system, typically benign, arising from the meninges.
• Complex meningiomas, such as those in the posterior fossa or parasagittal regions, present significant surgical challenges.
• Obstructive hydrocephalus is a potential complication of posterior fossa tumors due to mass effect on cerebrospinal fluid pathways.

Observation:

• A 58-year-old female patient presented with two distinct meningiomas: a tentorial meningioma in the posterior fossa and a parasagittal meningioma in the frontal region.
• The tentorial meningioma caused compression of the right cerebellar hemisphere and fourth ventricle, leading to obstructive hydrocephalus.
• The parasagittal meningioma was located on the left side of the frontal region.

Findings:

• The patient underwent a two-stage surgical procedure.
• Initial ventricular drainage was performed, followed by complete resection of the posterior fossa meningioma, including coagulation of its dural attachment.
• One month later, the parasagittal meningioma was totally removed with thorough coagulation of its dural attachment.

Implications:

• This case demonstrates the successful surgical management of multiple complex meningiomas.
• Complete resection of both meningiomas resulted in a positive patient outcome, with the patient regaining independence and normal activity levels.
• The staged surgical approach, including initial CSF diversion, was effective in managing obstructive hydrocephalus and facilitating tumor removal.