Romanian Neurosurgery (Jun 2011)

Convexity meningiomas posing difficult challenges for neurosurgeons

  • Kumar Ashish,
  • P. N. Pandey,
  • Ghani Arshad,
  • Jaiswal Gaurav

Journal volume & issue
Vol. 18, no. 2

Abstract

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Meningiomas have been intriguing since the time of Harvey Cushing. Although, most of them have been conquered by “today’s neurosurgeons”, still they can pose difficult challenges sometimes. Convexity meningiomas are relatively easier to tackle especially if they are not too large and do not displace critical neurovascular structures. However, they can complicate matters at times and hence, extreme precautions need to be practised. We report two such cases of convexity meningiomas with unusual set of events where one had an unusual post operative complication and the other had an unusual mode of presentation. Extradural hematomas (EDH) are a common complication after intracranial surgeries. They are usually picked up in the early post-operative scans and are managed according to their size and mass effect. The first patient is a 60 year old female where delayed EDH was detected after a sudden bout of hypertension after the initial scan after 48 hours of surgery was normal. Intraoperatively, middle meningeal artery (MMA) had re-bled due to this sudden rise in the blood pressure. Second case is a 33 year old female who presented with an intracerebral bleed due to hemorrhage within a convexity meningioma.

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