Meningioma Presenting as Acute Subdural Hematoma

Case Report

Austin Neurosurg Open Access. 2016; 3(1): 1046.

Meningioma Presenting as Acute Subdural Hematoma

Abrar A Wani*, Arif Sarmast, Nayil K Malik, Altaf U Ramzan and Zulfiqar Ali

Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, India

*Corresponding author: Abrar Ahad Wani, Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, J&K, India

Received: January 18, 2016; Accepted: March 22, 2016; Published: March 24, 2016


Meningioma is one of the commonest benign intracranial tumours which usually presents with gradual onset of symptoms. However in rare instances it can present with rapid neurological deterioration and spontaneous subdural hematoma is one of the possibilities. Multiple reasons for hemorrhage in meningioma have been proposed and the most common mechanism, involves rupture of the abnormal vasculature networks of the tumor. The other mechanism implicates intratumoral necrosis caused by rapid growth of the tumor or venous thrombosis. The third mechanism involves enlarged feeding arteries which become tortuous, less resistant to blood pressure changes and finally susceptible to rupture under stress. The fourth mechanism is stretching of subdural bridging veins caused by expansion of meningioma resulting in rupture. Whatever the etiology rapid evacuation of hematoma and tumour is needed to improve outcome of the patient. In this article, we present a rare case of intracranial meningioma presenting with acute subdural hematoma treated with surgery.

Keywords: Meningioma; Intracranial; Subdural hematoma; Surgery; Etiology


Meningioma usually manifests as a gradual onset of symptoms. The term “meningioma apoplecticum” issued to describe a rapid onset resulting from pathological conditions including tumoral hemorrhage [1]. Acute subdural hematoma resulting from the meningioma is exceedingly rare with the mechanism of hemorrhage from benign brain tumors being largely unknown [2].

Case Report

A middle aged female presented with sudden onset of headache with loss of consciousness. On examination she was decerebrating. There was no history of trauma or intake of anticoagulant or antiplatelet drugs. She was evaluated with CT scan and found to have right frontal convexity meningioma with acute subdural hematoma and midline shift (Figure 1). She underwent decompressive craniotomy and evacuation of SDH and excision of meningioma was done. The tumour was moderately vascular with lot of calcifications. There was no discrete source of bleeding intraoperatively. After one week she was completely normal and check CT scan showed only postoperative changes (Figure 2). Histopathology confirmed the tumour as meningioma.

Citation: Wani AA, Sarmast A, Malik NK, Ramzan AU and Ali Z. Meningioma Presenting as Acute Subdural Hematoma. Austin Neurosurg Open Access. 2016; 3(1): 1046.