Yamaguchi Shinya, Suzuki Satoshi O, Matsuo Yoshihiro, Uesaka Toshio, Matsukado Koichiro, Iwaki Toru
Department of Neurosurgery, Hamanomachi Hospital, Japan.
No Shinkei Geka. 2011 Jan;39(1):45-50.
We report the case of a 34-year-old woman who exhibited acute deterioration in her condition after cerebral angiography for evaluation of a large meningioma. She had undergone surgery and irradiation for a glioma in the right occipital lobe 23 years before this episode. She experienced incapacity at work. On CT and MRI, a large meningioma was detected on the left frontal convexity; this tumor was thought to be radiation-induced. Cerebral angiography was performed to assess the vascularization of the tumor. Her condition began to deteriorate 2.5 h after the cerebral angiography. CT revealed an increase in the mass of the tumor, and a high density area in the tumor. We immediately removed the tumor. Histopathological examination revealed the tumor to be a meningothelial meningioma. New hemorrhagic foci were identified in the tumor. In addition, macrophages containing hemosiderin were detected, and some of the tumor vessels exhibited hyaline degeneration. We suspected that angiography triggered bleeding in the meningioma, which was already predisposed to hemorrhage.
我们报告了一例34岁女性病例，该患者因评估大型脑膜瘤而进行脑血管造影后病情急性恶化。在此次发病23年前，她曾因右侧枕叶胶质瘤接受过手术和放疗。她出现了工作能力丧失。CT和MRI检查发现左额凸面有一个大型脑膜瘤；该肿瘤被认为是放疗诱发的。进行脑血管造影以评估肿瘤的血管形成情况。脑血管造影后2.5小时，她的病情开始恶化。CT显示肿瘤体积增大，肿瘤内出现高密度区域。我们立即切除了肿瘤。组织病理学检查显示肿瘤为脑膜内皮型脑膜瘤。在肿瘤中发现了新的出血灶。此外，检测到含有含铁血黄素的巨噬细胞，部分肿瘤血管呈现透明变性。我们怀疑血管造影引发了原本就易于出血的脑膜瘤出血。
