A giant invasive parasagittal meningioma with recurrent seizures in a young female: A case report and review of literature

Abstract

Introduction: Parasagittal meningiomas (PM) are very common intracranial lesion but their occurrence in young adult is very rare. Most giant PM are characterized with the invasion of the superior sagittal sinus and form very huge collaterals which makes surgical resection very difficult. The origin of meningioma is still a matter of debate which make our case much more puzzling. We therefore reviewed detailed literature on the etiologies of meningioma as well. Case presentation: We present a case of 24-years old young lady with history of seizures, blurred vision, intermittent tremors and occasional dropping of objects on the right arm. She had dizziness, headaches, tinnitus and paresthesia on the right side with loss of smell. She had a transient amaurosis fugax once before presenting to us. MRI done revealed a huge tumor compression on the left fronto-parietal gyrus and invading the superior sagittal sinus (SSS). The goal of surgery in this young lady was to preserve the SSS completely, stop frequent seizures and also preserve eloquent areas since the lesion was lying directly on the focal motor area. With a good preoperative evaluation and careful resection of the tumor, we achieved total resection without any further neurologic complications. Conclusion: We believe the etiology of meningioma in our patients started at childhood and progress to this giant status. We therefore suggest that neurosurgeon's screen children early to detect meningiomas before they advance into giant stages. Two years follow-up after surgery showed no tumor recurrence. Keywords: Parasagittal meningiomas (PM), Superior sagittal sinus (SSS), Seizures, Young female, Angiography