Meningioma associated with subdural haematoma: report of two cases and review of the literature

Recurrent acute subdural bleeding as a rare complication of a hemorrhagic non malignant meningioma.

“…Intracerebral and subarachnoid spaces (including ventricles) are the next frequent indolent course (8), clinical presentation of the rare cases of HSD associated with meningioma is frequently sudden, with quick impairment of consciousness and motor disorders. Fatal issue is observed in approximately 50% of those cases (6). In a review of 20 cases of SDH caused by meningioma, Chaskis et al (6) reported that most of the operated patients had a full or good postoperative neurological recovery.…”

“…Fatal issue is observed in approximately 50% of those cases (6). In a review of 20 cases of SDH caused by meningioma, Chaskis et al (6) reported that most of the operated patients had a full or good postoperative neurological recovery. Consequently, these patients should have rapid tumor surgical removal to get the maximum benefit (6, 7).…”

“…Chaskis et al (6) suggested that malignant histological sub-types of meningiomas could be associated to an increased risk of tumour-associated bleeding, but they included into their series "angioblastic meningiomas" which are now classified as meningeal hemangiopericytomas and were removed in the 2007 WHO classification of meningiomas group. Kashimura et al (10) adhered to this hypothesis, but for Worm et al (11) histological grading of the tumors failed to reveal significant relationship with hemorrhagic events.…”

“…In some cases, SDH could be secondary to intra-meningioma hemorrhage breaking through the tumor to the subdural spaces. The localization of the tumor at the cerebral convexity could be a risk factor for hemorrhage (6,8,11). …”

“…Intratumoral bleeding is observed in approximately 5% of intracranial tumors, commonly seen within pituitary adenomas, malignant gliomas and metastatic tumors (most often from melanoma, bronchogenic carcinoma, choriocarcinoma and hypernephroma) (5,6).…”