Tsuchiya Takahiro, Shinya Yuki, Inoue Tomohiro, Ohara Kenta, Morikawa Teppei, Tanishima Takeo, Tamura Akira, Saito Isamu, Ono Hideaki
Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya-shi, Shizuoka, Japan.
Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan.
Asian J Neurosurg. 2024 Jun 25;19(3):526-530. doi: 10.1055/s-0043-1771328. eCollection 2024 Sep.
The majority of meningiomas are slow-growing benign tumors that can potentially be highly vascularized; however, acute hemorrhagic onset is rare. Herein, we describe two patients who presented with disturbance of consciousness and severe hemiplegia due to spontaneous hemorrhage from a falx atypical meningioma. A 49-year-old female presenting with a sudden disturbance of consciousness and severe left hemiplegia was found to have a falx meningioma and acute hemorrhage. Emergent resection achieved neurological relief and tumor control. A 60-year-old female with aphasia and severe right hemiplegia also had falx meningioma and hematoma, and successfully treated by emergent resection. Tumor was diagnosed as atypical meningioma in both cases. Both patients achieved mid-term tumor control for 4 and 7 years. Both patients were treated successfully with emergent surgical resection, and neurological relief and mid-term tumor control (7 and 4 years, respectively) were achieved. Given this success, immediate surgical resection with hematoma evacuation should be considered an acceptable therapeutic option for acute hemorrhagic atypical meningioma.
大多数脑膜瘤是生长缓慢的良性肿瘤，可能具有高度血管化；然而，急性出血性发病很少见。在此，我们描述了两名因镰旁非典型脑膜瘤自发性出血而出现意识障碍和严重偏瘫的患者。一名49岁女性，突发意识障碍和严重左侧偏瘫，被发现患有镰旁脑膜瘤并急性出血。急诊切除实现了神经功能缓解和肿瘤控制。一名60岁女性，伴有失语和严重右侧偏瘫，也患有镰旁脑膜瘤和血肿，通过急诊切除成功治疗。两例肿瘤均诊断为非典型脑膜瘤。两名患者分别实现了4年和7年的中期肿瘤控制。两名患者均通过急诊手术切除成功治疗，实现了神经功能缓解和中期肿瘤控制（分别为7年和4年）。鉴于这一成功经验，立即进行手术切除并清除血肿应被视为急性出血性非典型脑膜瘤可接受的治疗选择。
