Three Cases of Frontal Meningiomas Presenting Psychiatrically

Hunter, Richard; Blackwood, W.; Bull, J. W. D.

doi:10.1136/bmj.3.5609.9

Cited by 69 publications

(30 citation statements)

References 15 publications

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“…14,18 Furthermore, an association between neuropsychiatric symptoms and the occurrence of meningiomas, in particular of the anterior fossa, has been observed. 1,2,13 Regarding postoperative neurocognitive outcomes, the literature suggests that about 40% of patients experience cognitive or emotional problems following surgery. 26 Patients with meningioma show significant long-term impairments in executive functioning; 6 those with skull base meningiomas perform lower on cognitive testing than those with convexity meningiomas, and those with leftsided meningiomas show more verbal memory deficits than those with right-sided meningiomas.…”

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confidence: 99%

Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Liouta

Koutsarnakis

Liakos

et al. 2016

JNS

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MeningioMas constitute approximately 15%-20% of all intracranial neoplasms and are often associated with favorable clinical prognosis because of their benign histology. Because of the high survival rates associated with meningiomas, patients with meningiomas can expect increased functional capacity compared with patients harboring other brain tumors. Parameters such as the rate of survival, tumor recurrence, and progression, 8 as well as the quality of life 3,17 of these patients, have traditionally been used to assess outcomes after intracranial meningioma surgery. According to recommendations from current outcomes research programs, neuropsychological-cognitive parameters also need to be incorporated to comprehensively evaluate surgical outcomes.Although meningiomas are extraaxial tumors, cognitive decline may arise due to perilesional edema and mass obJective Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. methods Patients with skull base (anterior and middle fossa) and convexity (anterior and posterior) meningiomas (n = 54) underwent neuropsychological examination prior to and 1 year after surgery. A control group (n = 52) of healthy volunteers matched for age, sex, and education underwent the same examination. Assessments included executive, memory, and motor functions with standardized testing. Patients with convexity meningiomas were clinically assessed for parietal association cortex functions. results All patients performed significantly worse (p < 0.05) in most neurocognitive domains than controls. The skull base group showed more disturbances in memory than the convexity group (p < 0.05). The anterior convexity group showed more deficits in executive function than the posterior convexity group, which presented with parietal association cortex deficits. Verbal deficits were more pronounced in the left hemisphere than in the right hemisphere. Patients with a large tumor (> 4 cm) had more severe neurocognitive deficits than those with a small tumor (< 4 cm). Postoperatively, patients showed no deterioration in neurocognitive function. Instead, significant improvement (p < 0.05) was observed in some executive, motor, and parietal association cortex functions. coNclusioNs According to the authors' findings, intracranial meningiomas may cause neurocognitive deficits in patients. Surgery does not cause a deterioration in cognitive function; instead, it may lead to improvements in some functions. Permanent neuropsychological postoperative deficits should be interpreted as tumor-induced rather than due to surgery.

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confidence: 99%

Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Liouta

Koutsarnakis

Liakos

et al. 2016

JNS

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“…There are reports of delay in diagnosing brain tumours which present predominantly with psychiatric symptoms. A silent meningioma that remained undiagnosed for 42 years has been reported (1) and in one series of parasagittal meningiomas 8% of patients had histories of more than 10 years, the longest being 37 years.…”

Section: Discussionmentioning

confidence: 99%

“…Tumours of brain can cause myriad of symptoms, either common to all tumours or specifically related to the location of the tumour (1) Brain tumours can present with psychiatric symptoms and without any localising sign often the association between psychiatric symptoms and tumour location or histological type is difficult to establish. Thus, it becomes important for a clinician to suspect intracranial growth in patients with new-onset psychiatric symptoms, atypical presentations or treatment resistance.…”

Section: Introductionmentioning

confidence: 99%

Frontal meningioma presenting as depressive episode: case report and a brief review of literature

2017

SUJHS

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Brain tumours have been notorious for impersonating as psychiatric disorders. In some cases, patients may only have psychiatric symptoms, such as mood changes (depression or mania), psychotic symptoms, panic attacks, changes in personality, or memory difficulties. The frontal lobes tumours of the brain are notoriously "silent and present only with atypical psychiatric symptoms. These may be detected in patients at their first presentation to mental health services or sometimes in patients with well-established psychiatric diagnoses. Thus, they often pose a diagnostic problem and may cause delay in actual treatment. We present a case of 27 years old female presenting with depressive symptoms and diagnosed to have frontal lobe Meningioma four years after the onset of symptoms. Our case illustrates the need for prompt and detailed assessment including brain-imaging studies when patient presents with atypical psychiatric symptoms to decrease the suffering of patient and family.

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“…Similarly, the literature has suggested a tendency for left-sided tumors to cause dysphoria and depression and for right-sided tumors to cause euphoria and symptom denial and neglect [9]. Hunter et al have reported cases of excitement and hallucinosis seen in association with a basal frontal lesion, and psychotic syndromes like hypomania and schizophrenia with tumor encroaching on the third ventricle and adjacent structures [10]. The association between slow growing frontal lobe tumors, anosmia and personality change is also one of the most celebrated in behavioral neurology [11].…”

Section: Discussionmentioning

confidence: 99%