Dang Danielle D, Mugge Luke, Awan Omar, Dang John, Shenai Mahesh
Neurological Surgery, Inova Hospital System, Falls Church, USA.
Internal Medicine, Walter Reed National Military Medical Center, Bethesda, USA.
Cureus. 2020 Nov 14;12(11):e11486. doi: 10.7759/cureus.11486.
While hemorrhage is commonly encountered in various intracranial tumors, it is relatively rare in benign meningiomas. We present an interesting case report of a 75-year-old male who fell during intoxication, sustaining right frontal cranial trauma, coincidentally directly overlying a previously undiagnosed right frontal meningioma. He experienced an acute neurological decline and was found to have an intracranial hematoma, causing significant mass effect and herniation. Based on the radiographic appearance, an underlying neoplasm with significant edema was suspected. Intraoperatively, the hematoma and mass were successfully evacuated, and post-operative pathology confirmed the presence of a World Health Organization Grade I meningioma with a microcystic and angiomatous pattern. We speculate on the mechanism of injury and hemorrhage in this patient through review of the literature and discussion of medical and pathological risk factors.
虽然出血在各种颅内肿瘤中很常见，但在良性脑膜瘤中相对少见。我们报告了一例有趣的病例，一名75岁男性在醉酒时摔倒，右额部颅脑外伤，巧合的是正好位于先前未被诊断出的右额部脑膜瘤上方。他出现急性神经功能衰退，被发现有颅内血肿，导致明显的占位效应和脑疝。根据影像学表现，怀疑存在伴有明显水肿的潜在肿瘤。术中成功清除了血肿和肿块，术后病理证实为世界卫生组织I级脑膜瘤，呈微囊性和血管瘤样模式。我们通过文献复习以及对医学和病理危险因素的讨论，推测了该患者的损伤和出血机制。
