Musculoskeletal complaints are highly common in southeast Iran. Knee and low back pain were the most common sites of complaints. The most frequent diagnosed diseases were osteoarthritis of knee followed by low back pain and soft tissue rheumatism. Rheumatoid arthritis was the most prevalent inflammatory disease.
Introduction
Meningiomas are the most commonly encountered intracranial tumors, usually showing indolent behavior. Extra-axial spreading and distant metastases are seldom detected in these tumors, and lung metastasis from a low-grade meningioma is a rare event.
Case presentation
This case report aimed to present the clinical, imaging, and pathological features of a 37-year-old Caucasian pregnant woman with bilateral lung metastases incidentally detected during preoperative workup ahead of surgery for a primary intracranial meningioma. The possible metastatic routes and risk factors of dissemination to the pulmonary circulation were discussed as well.
Conclusion
Metastasis must be considered in patients with intracranial meningiomas accompanied by venous sinus invasion and extension through the calvarium. Thorough paraclinical investigations are suggested in such cases.
Migrating intracranial bullets are a dilemma to neurosurgeons, as their management is challenging, and the removal process is associated with high mortality and morbidity rates. They are also associated with alterations in consciousness and focal neurological defects. We herein report a 40-year-old man with a retained intracranial AK-47 bullet for 22 years, admitted to our emergency department with decreased level of consciousness. He was diagnosed with meningitis and obstructive hydrocephalus, given the pressure effect of the bullet over the aqueduct of Sylvius. He underwent placement of external ventricular drainage (EVD) and received broad-spectrum antibiotics. However, he passed away due to complications of meningitis. Postmortem examination revealed that the bullet had entered the anterior perforated substance from ethmoidal air cells and migrated to the brain ventricular system in 22 years. Accordingly, conservative management of intracranial retained bullets is recommended.
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