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

Abstract

Meningioma is the most common nonglial intracranial primary tumor. It is a slowly growing tumor and presents clinically by causing seizures along with neurological or neuropsychological deficit. However, acute presentation of meningioma is possible. We are reporting a case of cerebral infarction due to a sphenoid wing meningothelial meningioma (with progesterone receptor positivity) leading to an occlusion of the middle cerebral artery (MCA) in a 30-year-old right-handed woman (1 month after childbirth). After surgery, no new neurological event occurred, and she recovered most of her neurological functions. Strokes due to meningioma are a highly rare clinical occurrence but should be given serious consideration, particularly in young patients.

Meningioma-Induced Transient Tumor Attacks Resembling Transient Ischemic Attacks

“…A possible explanation for the transient neurological deficit in our patient is related to her intracranial tumor causing partial impairment of cerebral blood flow [6,7]. Her neurologic findings were more consistent with findings of vascular insufficiency related to her tumor causing compression of her left anterior cerebral artery or from mass effect by the tumor.…”

Isolated Wrist Drop as the Sole Presentation of an Acute Embolic Ischemic Stroke

“…Considering the acute presentation and lack of any previous history of headaches, seizures, or focal neurological deficits, it was determined that the meningioma was unlikely to explain our patient’s wrist weakness. Meningiomas have rarely presented with transient ischemic attacks (TIAs) or strokes, but if they do, it occurs from the compression of the adjacent vasculature, which was not present in our case [ 9 , 10 ]. Additionally, the meningioma was located in the olfactory groove area, which is not responsible for hand movement.…”

Transcranial color‐coded sonography may indirectly reveal an intracranial meningioma

“…Compression of the MCA by sphenoidal meningiomas has been described in oncological surgical series and in patients with established ischemic stroke . However, its sonographic incidental finding and the associated “red flags” features which may suggest to prompt further investigations have never been reported.…”