Matsuoka Go, Eguchi Seiichiro, Ryu Bikei, Tominaga Tadasuke, Ishikawa Tatsuya, Yamaguchi Koji, Kawamata Takakazu
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
World Neurosurg. 2019 Apr;124:75-80. doi: 10.1016/j.wneu.2018.12.124. Epub 2019 Jan 5.
We came across a rare case of recurrent hemorrhage from a meningioma. Here, we describe this case and discuss the treatment strategies for recurrent hemorrhage from a meningioma using a literature review.
A 61-year-old woman with a history of 2 episodes of hemorrhage from a meningioma originating from the left falx cerebri presented to our outpatient clinic. She was asymptomatic, and magnetic resonance imaging revealed a small tumor along the falx cerebri. However, we decided to remove the hemorrhagic meningioma. No abnormal vascular structures were recognized on preoperative angiography and intraoperative evaluation. The tumor was easily removed along the falx cerebri (Simpson grade I). The pathologic diagnosis was transitional meningioma, World Health Organization grade I. The patient experienced no recurrence of tumor or hemorrhage for up to 15 months after surgery.
The incidence of repeated bleeding from meningiomas is very rare and is seldom reported because the mortality associated with hemorrhage in meningiomas is high (28%-50%). Immediate diagnosis and surgical treatment with both hematoma evacuation and tumor removal are crucial to avoid inadequate and delayed treatment that may cause mortality.
我们遇到了一例罕见的脑膜瘤复发出血病例。在此，我们描述该病例，并通过文献综述讨论脑膜瘤复发出血的治疗策略。
一名61岁女性因起源于左侧大脑镰的脑膜瘤有两次出血病史，前来我们的门诊就诊。她无症状，磁共振成像显示大脑镰旁有一个小肿瘤。然而，我们决定切除出血性脑膜瘤。术前血管造影和术中评估均未发现异常血管结构。肿瘤很容易沿大脑镰切除（辛普森一级）。病理诊断为过渡型脑膜瘤，世界卫生组织一级。患者术后长达15个月未出现肿瘤复发或出血。
脑膜瘤反复出血的发生率非常罕见，且很少有报道，因为脑膜瘤出血相关的死亡率很高（28%-50%）。立即诊断并进行手术治疗，包括血肿清除和肿瘤切除，对于避免可能导致死亡的治疗不足和延误至关重要。
