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脑膜瘤伴发自发性硬脑膜下血肿:两例报告及文献复习。

Meningioma Presenting with Spontaneous Subdural Hematoma: A Report of Two Cases and Literature Review.

机构信息

Department of Neurosurgery, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.

出版信息

World Neurosurg. 2019 Jul;127:150-154. doi: 10.1016/j.wneu.2019.03.248. Epub 2019 Apr 1.

Abstract

BACKGROUND

Although meningiomas are considered benign, encapsulated brain tumors, their distinct intracranial location can lead to devastating complications. Although a highly vascularized tumor, a rarely reported complication of meningioma is hemorrhage. To the best of our knowledge, only 19 cases of meningioma presenting with a subdural hematoma have been reported.

CASE DESCRIPTION

We have outlined the clinical presentation, radiological findings, and outcomes of 2 female patients with a diagnosis of a spontaneous subdural hematoma associated with meningioma. The coagulation profile was within normal limits for both patients. The postoperative histopathologic examination results showed an angiomatous/microcystic subtype of meningioma (patient 1) and meningothelial meningioma (patient 2). Both patients underwent right frontal craniotomy, resection of the dural-based tumor, and evacuation of the subdural hematoma.

CONCLUSIONS

We comprehensively reviewed the pertinent data for meningiomas presenting as subdural hematomas. The mechanism of hemorrhage in meningiomas remains unclear. Therefore, further studies are required to investigate the possible mechanisms of bleeding in such tumors.

摘要

背景

脑膜瘤虽被认为是包膜内的良性颅内肿瘤,但由于其特殊的颅内位置,可导致严重的并发症。脑膜瘤血供丰富,但脑膜瘤出血是一种罕见的并发症。据我们所知,仅有 19 例脑膜瘤并发硬膜下血肿的病例报告。

病例描述

我们总结了 2 例女性脑膜瘤患者的临床表现、影像学发现和转归,这 2 例患者均诊断为自发性硬膜下血肿。这两例患者的凝血功能检查均在正常范围内。术后组织病理学检查结果显示脑膜瘤为血管型/微囊型(患者 1)和脑膜上皮型(患者 2)。这两例患者均接受了右额开颅术,切除了硬脑膜基底肿瘤,并清除了硬膜下血肿。

结论

我们全面回顾了脑膜瘤表现为硬膜下血肿的相关数据。脑膜瘤出血的机制尚不清楚。因此,需要进一步研究以探讨此类肿瘤出血的可能机制。

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