Toader Corneliu, Covache-Busuioc Razvan-Adrian, Bratu Bogdan-Gabriel, Glavan Luca-Andrei, Serban Matei, Ciurea Alexandru Vladimir
Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, Bucharest, ROU.
Cureus. 2023 Dec 20;15(12):e50826. doi: 10.7759/cureus.50826. eCollection 2023 Dec.
This case report presents a comprehensive analysis of a 67-year-old patient diagnosed in 2017 with meningothelial meningioma, focusing on the challenges of managing such tumors and their neurological implications. Meningiomas, being the most common benign intracranial neoplasms, have a notable research gap regarding their association with seizures and motor deficits. This patient, who had a history of depressive disorder, persistent cephalalgia syndrome, and ataxic gait, initially presented with symptoms including ataxic gait, confusion, and headache. Imaging revealed a large, hyperdense right frontal meningioma with a significant mass effect. Following surgical resection, the patient experienced notable neurological improvement. However, in 2023, the patient re-presented with bradypsychia, bradykinesia, and memory disorders, indicating a recurrent meningioma. This case exemplifies the recurrence and complex management of meningiomas, particularly in elderly patients, and highlights the importance of individualized treatment strategies. Surgical resection remains the primary treatment approach, supplemented by radiotherapy in cases of recurrence or incomplete resection. The case underscores the need for advancements in therapeutic approaches to mitigate recurrence risks and enhance patient outcomes in meningioma management. This is especially pertinent given the tumor's predilection for older females and its varied neurological manifestations, such as ataxic gait and seizures.
本病例报告对一名2017年被诊断为脑膜皮型脑膜瘤的67岁患者进行了全面分析，重点关注此类肿瘤的管理挑战及其神经学影响。脑膜瘤是最常见的颅内良性肿瘤，但其与癫痫发作和运动功能障碍的关联存在显著研究空白。该患者有抑郁症、持续性头痛综合征和共济失调步态病史，最初表现为共济失调步态、意识模糊和头痛等症状。影像学检查显示右侧额叶有一个大的高密度脑膜瘤，具有明显的占位效应。手术切除后，患者的神经功能有显著改善。然而，2023年，患者再次出现精神迟缓、运动迟缓及记忆障碍，提示脑膜瘤复发。该病例例证了脑膜瘤的复发及复杂管理，尤其是在老年患者中，并强调了个体化治疗策略的重要性。手术切除仍然是主要的治疗方法，复发或切除不完全的病例辅以放射治疗。该病例强调了治疗方法取得进展以降低复发风险并改善脑膜瘤管理中患者预后的必要性。鉴于该肿瘤对老年女性的偏好及其多样的神经学表现，如共济失调步态和癫痫发作，这一点尤为重要。
