Itani Masahiko, Shitara Satoshi, Akiyama Yoshinori
Department of Neurosurgery, Tenri Hospital, Tenri, Nara, Japan.
Surg Neurol Int. 2020 Aug 29;11:263. doi: 10.25259/SNI_328_2020. eCollection 2020.
Meningiomas presenting with acute subdural hematomas are extremely rare. To the best of our knowledge, only 45 cases have been reported to date. We report on a case of a meningioma mimicking an acute subdural hematoma as well as a thorough literature review.
A 67-year-old man with no history of trauma was referred to our hospital with sudden onset of decreased level of consciousness and left hemiplegia. Computed tomography revealed an acute convexity subdural hematoma. Emergency surgery to remove the hematoma was performed. The hematoma was found to exist in the extra-axial space and the attached dura mater and pia mater remained intact. Pathological examination revealed a transitional meningioma, the World Health Organization Grade 1. Detailed medical history taken postoperatively revealed that a convexity meningioma had been diagnosed incidentally at another facility 1 year earlier.
Acute subdural hematomas due to meningiomas are rare, and establishing the cause is challenging. Prompt and precise diagnosis of such entities may afford patients a better prognosis.
伴有急性硬膜下血肿的脑膜瘤极为罕见。据我们所知,迄今为止仅报道过45例。我们报告一例酷似急性硬膜下血肿的脑膜瘤病例,并进行全面的文献综述。
一名无外伤史的67岁男性因突发意识水平下降和左侧偏瘫被转诊至我院。计算机断层扫描显示急性凸面硬膜下血肿。遂进行了清除血肿的急诊手术。发现血肿位于轴外间隙,附着的硬脑膜和软脑膜保持完整。病理检查显示为世界卫生组织1级的过渡型脑膜瘤。术后详细询问病史发现,1年前在另一家医疗机构偶然诊断出凸面脑膜瘤。
由脑膜瘤引起的急性硬膜下血肿罕见,病因诊断具有挑战性。对此类病症进行迅速而准确的诊断可能会给患者带来更好的预后。