Meningioma-related subacute subdural hematoma: A case report

Abstract

Background: Meningiomas are the most frequent benign head tumors, although spontaneous hemorrhage is a rare form of presentation of such lesions. Of all possible bleeding locations associated with them, the subdural space is one of the most uncommon, with very few cases reported worldwide. Case Description: A middle-aged woman presented with progressively worsening left-sided headache, initiated 2 weeks before, with no other complaints, denying any previous head trauma. Head computed tomography revealed a subacute left hemisphere subdural hematoma and left frontal, suggestive of meningioma on magnetic resonance imaging. Surgical treatment was performed with hematoma evacuation and lesion removal. Neuropathology showed a transitional meningioma with signs of hemorrhage. After surgery, no neurological deficits were registered, and headache abated. Conclusion: As we could not identify any other cause for the subacute subdural hematoma, hemorrhage from the meningioma was the most probable cause, and thus, we decided to remove it along with clot evacuation. Based on neuropathological findings, we propose an alternative mechanism for this spontaneous hemorrhage from the meningioma, involving the place where the periphery of the lesion insertion, the dura mater as the origin of the hemorrhage. Knowledge of this association could help define the best treatment in such cases.

Acute subdural hematoma caused by hemorrhagic falx meningioma: A case report and review of the literature

“…We compare meningiomas with subdural hematoma to those without bleeding ( Table 2 ) [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , 13 , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] . In cases of meningiomas with subdural hematoma, the median age is 62 (range: 4 m-85 y) years.…”

A case of microcystic meningioma associated with acute subdural hematoma in the posterior cranial fossa

“…Malignant gliomas and metastatic brain tumors are the most likely to cause intracranial hemorrhage, and meningiomas cause as few as 1.3%-2.4% of all cases [ 1 , 2 , 5 ]. Subarachnoid hemorrhage is the most common type of hemorrhage associated with meningioma, whereas subdural hematoma is rare, with 57 cases reported [ 1 , 4 ]. Among these 57 cases, the ratio of males to females was approximately 1:2, the most common location was the cerebral convexity (63%), and the most common pathological subtypes were meningothelial (43%) and angiomatous meningioma (9%) [1] .…”

“…Meningioma is one of the most common benign brain tumors and is characterized by abundant vascularity [1] , [2] , [3] , [4] , [5] . Intracranial hemorrhage tends to occur with malignant brain tumors such as glioblastomas or metastatic tumors, but is relatively rare in meningiomas [ 1 , 2 , 4 , 5 ]. Subarachnoid hemorrhage is the most common type of hemorrhage, whereas acute subdural hematoma is unusual [ 1 , 2 , 4 , 5 ].…”

“…Intracranial hemorrhage tends to occur with malignant brain tumors such as glioblastomas or metastatic tumors, but is relatively rare in meningiomas [ 1 , 2 , 4 , 5 ]. Subarachnoid hemorrhage is the most common type of hemorrhage, whereas acute subdural hematoma is unusual [ 1 , 2 , 4 , 5 ]. We present a unique case of microcystic meningioma associated with acute subdural hematoma in the posterior fossa.…”

Delayed-onset abducens nerve palsy following parafalcine meningioma complicated by subdural hematoma

“…Although they are highly vascular structures, meningiomas do not typically produce subdural hematoma (SDH). 2 Only 38 cases of meningioma associated with acute SDH have been reported in the English literature. 1 We report a delayed-onset abducens nerve palsy due to an SDH associated with a parafalcine meningioma.…”