Meningiomas presenting as Massive Intracerebral Hemorrhage

Report of Two Cases

Abstract

Two cases of massive intracerebral hemorrhage associated with meningioma are presented. The patients were admitted with apoplectic onset of sudden headache and deterioration of consciousness. Plain and enhanced computed tomography scans showed the presence of a tumor attached to the falx and a massive intracerebral hematoma adjacent to the tumor in each patient. In one of the cases angiography coincidently demonstrated a left internal carotid-posterior communicating aneurysm. Total removal of the tumor and evacuation of the hematoma were undertaken in the two cases, and clipping of the aneurysm was concomitantly performed in one of the cases. Histologically, these tumors were meningotheliomatous meningioma and transitional one. The postoperative course was uneventful. These patients were discharged in excellent condition. Hemorrhage from meningioma and meningioma associated with aneurysm are discussed.