Rapidly Expanding Lateral Ventricular Meningioma Presenting with Intraventricular Hemorrhage following Remote Whole Brain Radiation and Stereotactic Radiosurgery

Abstract

Intraventricular meningiomas are uncommon intracranial tumors and infrequently present with hemorrhage. With only 10 reported cases in the literature, it is exceedingly rare for meningiomas of the ventricular system to present with hemorrhage. To our knowledge, this is the first report of a patient presenting with an acute intraventricular hemorrhage in relation to a ventricular meningioma suspected to be radiation induced. In addition, we review the current literature on hemorrhagic intraventricular meningiomas and review the natural history of radiation-induced meningiomas.

Stereotactic radiosurgery for intraventricular meningioma: a systematic review and meta-analysis

“…Search retrieved 309 articles from Medline, Scopus, Embase, and Web of Science. After duplicate removal, 132 papers remained, of which 20 were included after the title/abstract screening stage [ 1 , 8 , 10 , 11 , 15 , 16 , 18 , 20 , 22 , 23 , 29 , 30 , 36 , 37 , 40 – 42 , 45 , 46 , 48 ] and 4 were retrieved from the bibliography review [ 2 , 6 , 33 , 43 ]. In the full-text review, 10 articles did not meet our inclusion criteria [ 8 , 11 , 20 , 29 , 37 , 41 , 42 , 45 , 48 ].…”

“…In the full-text review, 10 articles did not meet our inclusion criteria [ 8 , 11 , 20 , 29 , 37 , 41 , 42 , 45 , 48 ]. Among excluded articles, 5 did not apply SRS for the treatment of current IVM [ 16 , 22 , 30 , 36 , 40 ], 2 did not have patients with IVM [ 11 , 18 ], one was conference abstract [ 45 ], one did not have enough data [ 2 ], and one had multiple spinal hemangioblastomas along with IVM and without application of SRS [ 1 ]. Overall, 14 articles matched our inclusion criteria [ 6 , 8 , 10 , 15 , 20 , 23 , 29 , 33 , 37 , 41 – 43 , 46 , 48 ].…”

Untitled

“…It is also very uncommon for lateral intraventricular meningiomas to present with hemorrhage, with only 11 cases reported in other over 600 cases in the literature of lateral ventricle meningiomas. [19,20] While the exact mechanism of hemorrhage in these lateral ventricle meningiomas is unknown, several theories have been proposed, which may help to provide an explanation of our third ventricle case. ese mechanisms include abnormal development of the vascular network within the meningioma, [11] internal necrosis due to rapid growth resulting in venous thrombosis and hemorrhage, [10] and disruption of the vascular blood supply due to tortuous and over-dilated arteries that lose their ability to regulate blood pressure.…”

Third ventricle World Health Organization Grade II meningioma presenting with intraventricular hemorrhage and obstructive hydrocephalus: A case report and literature review

“…It is also very uncommon for lateral intraventricular meningiomas to present with hemorrhage, with only 11 cases reported in other over 600 cases in the literature of lateral ventricle meningiomas. [19,20] While the exact mechanism of hemorrhage in these lateral ventricle meningiomas is unknown, several theories have been proposed, which may help to provide an explanation of our third ventricle case. These mechanisms include abnormal development of the vascular network within the meningioma,[11] internal necrosis due to rapid growth resulting in venous thrombosis and hemorrhage,[10] and disruption of the vascular blood supply due to tortuous and over-dilated arteries that lose their ability to regulate blood pressure.…”