PMC3204441_01
CT at the time of onset of intraventricular hemorrhage. A-B: A space-occupying lesion in the trigone of the left lateral ventricle was observed; it had a low-density cystic shadow in the middle (arrow). A high-density calcification shadow was detected at the rear of the lesion, and the surrounding brain tissues were mildly compressed. C: Hemorrhage surrounded the lesion and formed a hematoma, which extended forward into the lateral ventricle, and the hemorrhage affected the third ventricle (arrow). D: The hemorrhage also affected the fourth ventricle (arrow).
ijmsv08p0711g01.jpg
PMC3204441_01_ijmsv08p0711g01.jpg
F1
Hemorrhage surrounded the lesion and formed a hematoma, which extended forward into the contralateral ventricle and affected the third and fourth ventricles (Figure 1).
CTA after the onset of intraventricular hemorrhage. A: No intracranial artery malformation was observed; medial blood vessels of the tumor in the trigone of the lateral ventricle were disordered, and the tumor was supplied by anterior and posterior choroidal arteries (oval area). B: Maximum intensity projection revealed a high-density shadow in the trigone of the left lateral ventricle; the surrounding vessels were disordered, and a high-density calcification shadow was detected at the rear of the lesion (arrow).
ijmsv08p0711g02.jpg
PMC3204441_01_ijmsv08p0711g02.jpg
F2
Maximum intensity projection clearly revealed a high-density calcification shadow at the rear of the lesion, and the surrounding brain tissues were mildly compressed (Figure 2).
MRI examination. A-B: A 2.86 cm x 2.68 cm space-occupying lesion was detected in the trigone of the left lateral ventricle; T1WI and T2WI showed mixed signals, and a cystic shadow was noted within the lesion. Slightly high abnormal T1WI and T2WI signals in the bilateral lateral ventricles were observed, and fluid was visible in the occipital horn of the left lateral ventricle (arrow).
ijmsv08p0711g03.jpg
PMC3204441_01_ijmsv08p0711g03.jpg
F3
Slightly high abnormal T1WI and T2WI signals were noted in the bilateral lateral ventricles, and fluid was visible in the occipital horn of the left lateral ventricle (Figure 3).
Postoperative CT. A: Re-examination at day 7 post operation showed that the tumor had been removed but that severe edema surrounded the lesion and the midline had shifted to the opposite side. B: After decompression, there was still edema surrounding the trigone of the lateral ventricle, but the midline was located in the middle.
ijmsv08p0711g04.jpg
PMC3204441_01_ijmsv08p0711g04.jpg
F4
Emergency treatment with decompression via bone removal was performed (Figure 4).
Pathological examination. A: The tumor was composed of fusiform cells; the shape of the cells was between that of endothelial and fibroblast types (i.e., transitional type; WHO-Grade I). B: Cystic cavities were seen in the tumor tissues (arrow). C: Patchy hemorrhage was observed inside the tumor, within which dilated tortuous blood vessels were observed (arrow).
ijmsv08p0711g05.jpg
PMC3204441_01_ijmsv08p0711g05.jpg
F5
Thus, the lesion was diagnosed as transitional meningioma (WHO-Grade I) (Figure 5).