Meningioma Manifesting as Cerebral Infarction -Case Report-

Abstract

A previously healthy 31-year-old man presented with an extremely rare case of small meningioma associated with cerebral infarction preceded by recurrent transient ischemic attacks manifesting as a 3-day history of recurrent and transient weakness of the left lower limb lasting several minutes for each episode. The symptoms became persistent and complete on the following day. Magnetic resonance imaging revealed acute cerebral infarction in the right frontal lobe and a 20 mm diameter tumor in the planum sphenoidale encasing the right anterior cerebral artery. Cerebral angiography demonstrated occlusion of the right A 2 portion. The patient underwent surgery and the tumor was gross totally removed. The histological diagnosis was meningothelial meningioma. Cases of meningioma causing cerebral infarction are very rare, but the possibility should be considered even if the tumor is small.

A Rare Cause of Stroke in Young Adults: Occlusion of the Middle Cerebral Artery by a Meningioma Postpartum

“…It has been suggested that meningiomal compression of the carotid artery may produce transient neurological symptoms including loss of consciousness, hemiparesis, paresthesia, and global transient amnesia [6]. However, complete cerebral infarction due to meningioma is exceedingly rare, and to our knowledge, only 6 other cases have been previously reported [7–10]: among these cases (including ours), 4 were MCA infarcts, 1 was an anterior cerebral artery infarct, 1 was a posterior watershed stroke, and 1 was a pontine infarct. Most of the patients were under 50 years of age.…”

Sphenoid ridge meningioma presenting as ischemia stroke

“…Meningioma could result in acute infarction of the MCA as in the case of ICA and anterior cerebral artery 1,2 . We suspect that hypoperfusion resulted from external compression by the meningioma, and artery‐to‐artery thromboembolization contributed to the pathophysiology of our patient's hemiparesis.…”

“…The incidence of acute cerebral infarct, as reported in the internal carotid artery (ICA) territory, resulting from arterial occlusion or obstruction related to meningioma is very rare 1 . This rarity is characterized by high pressure in the arterial vasculature, which is well compensated by collateral flow through the circle of Willis, and the arachnoid plane is well preserved 1,2 …”

Sphenoid Ridge Meningioma Presenting as Acute Cerebral Infarction

“…Nevertheless, the incidence of complete cerebral infarction resulting from arterial occlusion or obstruction related to meningioma is extremely rare4,9,13,15). We have summarized the reported cases from English literature of complete cerebral infarction caused by a meningioma in Table 1.…”

“…Transient ischemic attack is a known complication of skull base meningioma. However, acute cerebral infarction, resulting from intracranial arterial occlusion or obstruction related to meningioma is extremely rare4,9,13,15). Here, the authors report a case of sphenoid ridge meningioma presenting with acute cerebral infarction caused by middle cerebral artery (MCA) compression.…”