PDF(Pubmed)
Abstract：
A meningioma is a rare primary CNS tumor that tends to present more so in females in a slowly progressive fashion. The cavernous sinus and cerebellopontine angle are uncommon locations for meningiomas. We present a case of a meningioma in a 60-year-old female presenting to the emergency department for a sudden onset headache, vertigo, facial paresthesias, and chest pain. Inpatient workup revealed orthostatic hypotension, a meningioma spanning from the left cavernous sinus to the left cerebellopontine angle encasing the left cavernous internal carotid artery on MRI and CTA, and an incidental 12 mm calcified fibroadenoma on CT. Hospital course consisted of supportive treatment, physical rehabilitation, and review of previous imaging to determine need for intervention per consultants\' recommendations. The patient was discharged with an antiplatelet, an antihistamine, appropriate additional medications, a vestibular therapy script, and outpatient referrals for a decision regarding surveillance and intervention. Overall, this case describes some key points. It demonstrates that cavernous sinus and cerebellopontine angle meningiomas can occur simultaneously, especially as a continuous mass, which very few cases have done so far. It also highlights an acute clinical presentation of a meningioma, contrary to the gradually progressive one observed in most instances. Last, but not least, it shows how nonspecific symptoms can lead to unique findings at times.
摘要：
脑膜瘤是一种罕见的原发性中枢神经系统肿瘤，在女性中以缓慢进展的方式表现得更多。海绵窦和桥小脑角是脑膜瘤的少见部位。我们介绍了一例脑膜瘤的60岁女性，因突发性头痛而到急诊科就诊，眩晕,面部感觉异常,和胸痛。住院检查显示直立性低血压，在MRI和CTA上，从左海绵窦到左小脑桥脑膜角的脑膜瘤包围了左海绵状颈内动脉，和CT上偶然出现的12毫米钙化纤维腺瘤。医院疗程包括支持性治疗，身体康复,并根据顾问的建议审查以前的成像，以确定是否需要干预。病人服用抗血小板药物出院,抗组胺药,适当的额外药物，前庭治疗脚本，和门诊转诊，以决定监测和干预。总的来说,这个案例描述了一些关键点。这表明海绵窦和桥小脑角脑膜瘤可以同时发生，尤其是作为一个连续的质量，到目前为止，很少有案例这样做。它还强调了脑膜瘤的急性临床表现，与大多数情况下观察到的逐渐进步相反。最后,但并非最不重要的,它显示了非特异性症状如何有时会导致独特的发现。
