PMC4841328_01
Preoperative CT scan showing the extent of the hemorrhage in the (A) axial and (B) coronal plane as well as (C) marked vasculature in the lateral part of the hematoma (black arrow), masking the underlying tumor.
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Her computed tomography (CT) scan showed an intracerebral hemorrhage 45 x 67 x 54 mm, localized mainly in the left temporal lobe, but extending also to the basal part of the left frontal lobe, and giving approximately 1 cm mid-line shift toward the right side (Figs. 1A and B). Although the hemorrhage was centered around the left Sylvian fissure, CT angiography revealed neither intracranial aneurysm nor arteriovenous malformation, only a dislocation of the middle cerebral artery and marked vasculature in the lateral part of the hematoma (Fig. 1C).
CT control one day after surgery.
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The CT taken on the following day (Fig. 2) showed no significant remaining hematoma; there were signs of ischemic damage in the surrounding brain tissue, but the cerebral vasculature was open without vasospasms.
Histopathological findings supporting the diagnosis of meningothelial meningioma (WHO grade I) in the (A) hematoxylin/eosin, (B) trichrome (connective tissue), and (C) Ki67 (proliferation marker) staining.
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Focally, degenerative features such as nuclear atypia and myxoid degeneration demonstrated by Alcian Blue stain were present, whereas tumor and vessel wall necrosis and vessel wall and brain tissue invasion were absent (Figs. 3A-C).