Benign meningioma manifesting with acute subdural hematoma and cerebral edema

Benign meningioma
Preoperative axial computed tomography showing an acute subdural hematoma extending to the right fronto-temporo-parietal area (a, arrows) and a round-shaped, high-density mass on the right parietal convexity (b, arrow).

Benign meningioma

Hyper vascular or malignant tumour are rare representations of subdural hematoma, and the frequency is even lesser in benign tumours, for example meningiomas. However, that wasn’t the case for the 53-year-old Asian woman with subdural hematoma associated with benign meningioma.

She presented in the emergency with a complaint of severe headache and vomiting for the past two days. Her symptoms showed no trauma. There was no previous medical history either and all her labs were within the normal range. 

Her vitals were normal, and the initial neurological exam showed alert consciousness. There was no sign of abnormality.

CT Results

The CT scan of the brain revealed SDH on the right side with a focal, round shaped, high-density mass in the parietal convexity.

MRI Results

Brain MRI demonstrated a heterogeneously enhanced, round extra axial mass with diffuse SDH in the right fronto-parietal area. Moreover, mild midline shifting was also seen.

The patient was sent to surgery to remove the subdural hematoma and for the removal of the concurrent tumor on the ipsilateral parietal convexity. During surgery, a hypervascular encapsulated mass was identified. It was removed completely, including the adjacent dura mater.

Histo Confirmed Angiomatous Meningioma 

The histopathology test confirmed that the tumor was an angiomatous meningioma. The clinical course she went through was uneventful. She was admitted into the neurosurgical department, where she was medically managed for increased intracranial pressure. Mannitol was administered intravenously, and steroid was also given. 

Abrupt Deterioration of Neurological Status

The very next day, her neurological status deteriorated suddenly, resulting in stupor. The follow-up CT scan revealed uncal herniation and there was no increase in the SDH volume.

Meningiomas are supposedly benign based on their histological traits. They can cause spontaneous bleeding and unstableness neurologically. Hence, meningiomas are supposedly


Benign meningioma manifesting with acute subdural hematoma and cerebral edema: a case report and review of the literature

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.


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