MNGA-02 MENINGIOMA WITH CONTROLATERAL SUB-DURAL HEMATOMA: CASE REPORT AND LITERATURE REVIEW Open Access

Meningiomas account for around 20% of primary intracranial tumors. It is the most common benign brain tumor. The association of meningiomas with subdural hematoma is rare, and very few cases have been reported in the literature. The pathophysiological mechanisms are not yet fully understood. We therefore report a case of chronic subdural haematoma associated with a meningioma and review the relevant literature.

A 72-year-old patient with known hypertension and a right basifrontal lesion discovered a few months previously. He was brought to emergency by his daughter for multiple comitial seizures and confusion. On clinical examination, the patient was conscious but confused, with anosmia and no sensory or motor deficits. A brain scan and MRI revealed a right parasagittal basifrontal meningioma associated with a chronic left subdural hematoma. The patient had no coagulation disorders. He underwent removal of the meningioma using a bifrontal approach, cranialisation of the sinuses, and drainage of the hematoma using an external subdural shunt. The postoperative course was favorable. Post-operative imaging showed satisfactory Simpson 1 resection and good drainage. The anatomopathological examination concluded that the meningioma had a meningothelial morphological subtype of doubtful invasiveness, suggesting a grade 2 invasive meningioma or a grade 1 meningothelial meningioma. No additional treatment was required.

The presence of a meningioma should always be suspected in the presence of an acute non-traumatic subdural hematoma. To obtain a more comprehensive pathophysiological explanation of the association, a meta-analysis involving a larger number of cases and a larger series would be necessary.