Brain Tumor Res Treat.  2019 Oct;7(2):151-155. 10.14791/btrt.2019.7.e41.

Lateral Ventricular Meningioma Presenting with Intraventricular Hemorrhage

Affiliations
  • 1Department of Neurosurgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. neurocha@hanmail.net

Abstract

A 35-year-old female visited emergency department for a sudden onset of headache with vomiting after management for abortion at local department. Neurological examination revealed drowsy mentality without focal neurological deficits. CT showed 3.2×3.4 cm hyperdense intraventricular mass with intraventricular hemorrhage. The intraventricular hemorrhage was found in lateral, 3rd, and 4th ventricles. MRI showed well enhancing intraventricular mass abutting choroid plexus in the trigone of the right lateral ventricle. CT angiography showed tortuous prominent arteries from choroidal artery in tumor. Her neurological status deteriorated to stupor and contralateral hemiparesis during planned preoperative workup. Urgent transtemporal and transcortical approach with decompressive craniectomy for removal of intraventricular meningioma with hemorrhage was done. Grossly total removal of ventricular mass was achieved. Pathological finding was meningotheliomatous meningioma of World Health Organization (WHO) grade I. The patient recovered to alert mentality and no motor deficit after intensive care for increased intracranial pressure. However, visual field defect was developed due to posterior cerebral artery territory infarction. The visual deficit did not resolve during follow up period. Lateral ventricular meningioma with spontaneous intraventricular hemorrhage in pregnant woman is very uncommon. We report a surgical case of lateral ventricular meningioma with rapid neurological deterioration for intraventricular hemorrhage.

Keyword

Meningioma; Hemorrhage; Pregnancy

MeSH Terms

Adult
Angiography
Arteries
Choroid
Choroid Plexus
Critical Care
Decompressive Craniectomy
Emergency Service, Hospital
Female
Follow-Up Studies
Fourth Ventricle
Headache
Hemorrhage*
Humans
Infarction
Intracranial Pressure
Lateral Ventricles
Magnetic Resonance Imaging
Meningioma*
Neurologic Examination
Paresis
Posterior Cerebral Artery
Pregnancy
Pregnant Women
Stupor
Visual Fields
Vomiting
World Health Organization
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