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Washington University Experience | NEOPLASMS (MENINGIOMA) | Gross Pathology | 34A0 Case 34 History
Case 34 History (AANP 1995-11) ---- The patient was a 21 year old left handed woman who fell off a horse in September, 1994, and suffered a concussion. Skull x-ray and CT scan showed a large bilateral occipital extra-axial mass with hyperostosis of the overlying bone. A subsequent MRI revealed invasion of the calvarium and extracalvarial extension of this lesion. There was also a 2 cm enhancing cystic mass in the right posterior parietal lobe adjacent to the extra-axial mass. In retrospect, the patient had noted increasingly frequent headaches for the last one and a half years, with occasional episodes of dizziness. She had no witnessed seizures, and had had a decrease in her peripheral vision, but denied diplopia. The patient had also noted increasing proptosis for the last year. The patient was admitted in October, 1994, underwent cerebral angiography and successful PYA embolization of her right middle meningeal artery, right occipital artery, and left middle meningeal artery. Also noted during this procedure was occlusion of her superior sagittal sinus at the tumor site. The anterior superior sagittal sinus drained via the anterior cortical veins to the ophthalmic veins via transosseous emissary veins. The patient tolerated this procedure well. A few days later she had a bilateral parietooccipital craniectomy for tumor excision and methyl methacrylate cranioplasty. Recovery from these procedures were uneventful.
