Han Song, Yang Yakun, Yang Zuocheng, Liu Ning, Qi Xueling, Yan Changxiang, Yu Chunjiang
Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China.
Department of Pathology, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, P.R. China.
Oncol Lett. 2020 Jul;20(1):785-793. doi: 10.3892/ol.2020.11590. Epub 2020 May 6.
The aim of the present study was to explore the clinical characteristics of repeated hemorrhages of meningioma and analyze the causes of hemorrhage. Meningiomas are mostly benign tumors that rarely manifest hemorrhagic strokes. In the present study, a case of sphenoid ridge meningioma with repeated hemorrhages is reported. Internal hemorrhage was first observed, which, on further aggravation, formed a hematoma in the brain parenchyma and finally led to the development of a hernia. No neurological deficit was present after surgery and rehabilitation. A postoperative pathological examination showed increased levels of Ki-67, abnormal blood vessels in the tumors and the presence of progesterone, which indicate possible causes of the hemorrhage. A review of associated previous studies revealed that hemorrhages originate mainly from inside the meningioma. Two cases of meningiomas with repeated hemorrhages have been reported; one in the foramen magnum region and the other in the pineal gland area. The foramen magnum tumor had an interval of 1.33 months between two hemorrhagic episodes. Collecting relevant data from the latter case was not possible. In the present case report, the interval between two bleeding episodes was 3 days. The literature review also revealed that the average age of onset of meningioma is relatively young at only 28.00±6.24 years. In conclusion, repeated hemorrhages in meningiomas are extremely rare and the causes have not yet been identified. Increased Ki-67 and abnormally proliferating blood vessels may be potential causes of hemorrhage. Early diagnosis and rapid surgical intervention are essential to prevent further episodes of bleeding, which may otherwise have fatal consequences for the patients.
本研究的目的是探讨脑膜瘤反复出血的临床特征并分析出血原因。脑膜瘤大多为良性肿瘤，很少表现为出血性卒中。在本研究中，报告了1例蝶骨嵴脑膜瘤反复出血的病例。首次观察到颅内出血，进一步加重后在脑实质内形成血肿，最终导致脑疝形成。手术及康复后未出现神经功能缺损。术后病理检查显示Ki-67水平升高、肿瘤内血管异常以及存在孕激素，这些提示了可能的出血原因。回顾相关既往研究发现，出血主要起源于脑膜瘤内部。此前已报告2例脑膜瘤反复出血的病例，1例位于枕骨大孔区，另1例位于松果体区。枕骨大孔区的肿瘤两次出血发作间隔为1.33个月。无法收集后1例病例的相关数据。在本病例报告中，两次出血发作间隔为3天。文献综述还显示，脑膜瘤的平均发病年龄相对较轻，仅为28.00±6.24岁。总之，脑膜瘤反复出血极为罕见，其原因尚未明确。Ki-67升高和血管异常增生可能是出血的潜在原因。早期诊断和快速手术干预对于预防进一步出血发作至关重要，否则可能会给患者带来致命后果。
