Aoyama Yu-Ichi, Ohta Shinsuke, Sakaki Saburou, Fujita Toyohisa
Department of Neurosurgery, Shiraniwa Hospital.
No Shinkei Geka. 2015 May;43(5):445-50. doi: 10.11477/mf.1436203044.
A 59-year-old woman was admitted with to our hospital with a sudden severe headache that had lasted for 5 days. Neck stiffness was present, but no other neurological deficits were present. Subarachnoid hemorrhage and intra-tumor hemorrhage were not noted on a head computed tomography (HCT). The patient's cerebrospinal fluid was xanthochromic. Magnetic resonance imaging (MRI) demonstrated a gadolinium-enhanced tumor with hemorrhagic changes around the foramen magnum. After conservative therapy, MRI showed a decrease in tumor size and a dural tail sign. This tumor was diagnosed as a hemorrhagic meningioma, and was resected with a posterior suboccipital approach. Histology confirmed that this tumor was a benign transitional meningioma with hemorrhagic change. This is a rare case involving benign meningioma onset by hemorrhagic change. Postoperative tumor recurrence was not present.
一名59岁女性因突发剧烈头痛持续5天入院。存在颈部僵硬,但无其他神经功能缺损。头颅计算机断层扫描(HCT)未发现蛛网膜下腔出血和肿瘤内出血。患者脑脊液呈黄变。磁共振成像(MRI)显示枕骨大孔周围有一个钆增强的肿瘤并伴有出血改变。保守治疗后,MRI显示肿瘤大小减小且有硬脑膜尾征。该肿瘤被诊断为出血性脑膜瘤,并采用枕下后入路进行切除。组织学证实该肿瘤为伴有出血改变的良性过渡性脑膜瘤。这是一例罕见的因出血改变而发生的良性脑膜瘤病例。术后未出现肿瘤复发。