Xiong Tao, Liu Wei-Xian, Tang Zhu-Xiao, Ma Jiang-Chun, Sun Hu
Department of Neurosurgery, Brain Center, Zhejiang Hospital, Hangzhou, Zhejiang, China.
Front Oncol. 2025 May 16;15:1517778. doi: 10.3389/fonc.2025.1517778. eCollection 2025.
Growth of meningiomas secondary to postoperative chronic subdural hematoma is extremely rare. Here, we present the first report of a patient who developed a meningioma within the outer membrane of the chronic subdural hematoma after burr-hole drainage for a traumatic chronic subdural hematoma.
A 75-year-old man underwent burr-hole drainage for a traumatic chronic subdural hematoma on the left side three years prior to presentation. Postoperative follow-up computed tomography revealed no recurrence of chronic subdural hematoma. The patient was admitted because of dizziness and immediately underwent magnetic resonance imaging (MRI), which also showed no recurrence of the chronic subdural hematoma; however, an abnormal signal lesion was identified in the left frontal region. Consequently, an enhanced MRI examination was performed, which indicated significant contrast enhancement, suggesting the diagnosis of meningioma. Subsequently, a frontotemporal craniotomy was performed, and the pathological diagnosis confirmed a meningioma (meningothelial type, World Health Organization grade I). Interestingly, during the craniotomy, the meningioma grew under the outer membrane of the chronic subdural hematoma, fused with the membrane, adhered tightly, and could not be separated. Fifteen months postoperatively, the patient was in good condition with no tumor recurrence.
Meningioma growth beneath the outer membrane of traumatic chronic subdural hematoma following burr-hole drainage has not been previously reported, which further highlights the probable significant role of trauma and chronic subdural hematoma-induced inflammatory stimulation in meningioma occurrence and development.
术后慢性硬膜下血肿继发脑膜瘤生长极为罕见。在此，我们报告首例患者，其在因创伤性慢性硬膜下血肿行钻孔引流术后，慢性硬膜下血肿外膜内发生了脑膜瘤。
一名75岁男性在就诊前三年因左侧创伤性慢性硬膜下血肿接受了钻孔引流术。术后随访计算机断层扫描显示慢性硬膜下血肿无复发。患者因头晕入院，随即接受磁共振成像（MRI）检查，结果也显示慢性硬膜下血肿无复发；然而，在左额叶区域发现了一个异常信号病灶。因此，进行了增强MRI检查，结果显示有明显的对比增强，提示诊断为脑膜瘤。随后，进行了额颞开颅手术，病理诊断证实为脑膜瘤（脑膜内皮型，世界卫生组织一级）。有趣的是，在开颅手术中，脑膜瘤在慢性硬膜下血肿的外膜下生长，与该膜融合，紧密粘连，无法分离。术后15个月，患者状况良好，无肿瘤复发。
钻孔引流术后创伤性慢性硬膜下血肿外膜下发生脑膜瘤生长此前未见报道，这进一步凸显了创伤和慢性硬膜下血肿诱导的炎症刺激在脑膜瘤发生发展中可能起的重要作用。
