Papillary meningioma: a rare cause of massive supratentorial intracerebral hemorrhage.
Preci L HamiltonPeyton LawrenceChristian Valentin EisenringPublished in: Journal of surgical case reports (2020)
Papillary meningioma (PM) represents a very rare histological subtype, which may present with massive intracerebral hemorrhage. Gross total tumor resection results in a lower recurrence rate and mortality. A 69-year-old man had been experiencing headache for 6 months. After exacerbating right frontal headache, he was brought to the emergency room. His Glasgow Coma Scale (GCS) was 11/15 and he had a left-sided hemiparesis. A computed tomography brain scan revealed a massive right frontal intracerebral hematoma with transtentorial herniation. During right frontal craniotomy and blood clot evacuation, a fleshy, pigmented tissue was encountered. Histopathological findings were consistent with PM World Health Organization Grade III. Complete tumor resection, Simpson II was achieved with a second operation. The hemiparesis and GCS normalized subsequently. The diagnosis of PM relies largely on histopathology and is not commonly encountered preoperatively in emergency cases. Staged surgery in this case resulted in a good outcome.
Keyphrases
- particulate matter
- computed tomography
- air pollution
- functional connectivity
- resting state
- polycyclic aromatic hydrocarbons
- working memory
- emergency department
- public health
- heavy metals
- brain injury
- minimally invasive
- water soluble
- healthcare
- positron emission tomography
- cardiovascular events
- magnetic resonance imaging
- coronary artery bypass
- white matter
- optic nerve
- cardiovascular disease
- emergency medical
- single cell
- dual energy
- risk factors
- percutaneous coronary intervention
- contrast enhanced
- coronary artery disease
- free survival
- children with cerebral palsy