Massive intracranial hemorrhage caused by intraventricular meningioma: case report

Abstract

Background Meningiomas are the most common benign intracranial tumors, and commonly comprise high-vascularizing but slow-growing tumors. On the other hand, meningiomas arising from the ventricular system are of rare occurrence, and spontaneous hemorrhage is an infrequent event. Case presentation We describe here the rare clinical manifestations of a 28-year-old female with acute intracranial hemorrhage located in the trigone of the lateral ventricle who was initially thought to have suffered an acute cerebrovascular accident, but was subsequently confirmed to have a benign intraventricular meningioma. To clarify the clinical features of such a rare course of meningioma, we also present a short literature review of acute intracranial hemorrhage caused by intraventricular meningioma. Conclusions Ventricular meningioma presenting with hemorrhage such as acute stroke is a rare event, but recognition of such a pathogenesis is important. Although further accumulation of clinical data is needed, we suggest that early surgery should be undertaken in patients with lateral ventricular meningioma, even if it is not so large or asymptomatic.

Acute Hemorrhagic-Onset Atypical Meningioma: A Report of Two Cases with Emergent Resection Achieving Mid-Term Tumor Control and Neurological Preservation

“…11 Many clinicians believe that early intervention should be undertaken in patients with lateral ventricular meningioma, even if it is small or the patient is asymptomatic. 12 However, the appropriate timing for surgical intervention remains controversial. Furthermore, the mid-to long-term outcomes of these patients remain unknown.…”

“…6,11 Intraventricularly, convexity, parasagittal, and falx cerebri tumors, and those that are malignant, fibrous, mesotheliomatous, or angioblastic are most likely to cause tumor-related hemorrhage. 11,12 The associated morbidity rates are high, reportedly accounting for 36% of the overall major morbidity rate. 11 Mortality rates are also high, reportedly reaching up to 21.1%, but falling to 9.5% with surgical intervention.…”

Primary central nervous system lymphoma of the third ventricle with intra‑tumoral hemorrhage: A case report and literature review

“…PCNSL with ITH reveals overexpression of vascular endothelial growth factor (VEGF), and progression of angiogenesis and breakdown of fragile vessels may cause ITH ( 13 , 32 ). Meanwhile, in specific intraventricular tumors, angiomatous lesions and abnormalities of the draining vein, such as venostasis and venous thrombosis in the subependymal layer arising from tumor extension may lead to ITH ( 14 , 33 , 34 ). In addition, a significant change in ICP may alter a cause of ITH in intraventricular tumors ( 35 ).…”