Meningiomas are classified into three types according to the World Health Organization classification system which is based on morphologic criteria. Type 1 is the benign variant, in which meningothelial is the most common subtype. Angiomatous also belongs to the same subtype but comprises only 2.1% of all meningiomas. Although most meningiomas are asymptomatic, some may present with varying symptoms ranging from seizures to focal deficits. Often, large meningiomas can also manifest as neuropsychiatric symptoms ranging from depression to overt psychosis. Here, in this case, we have further elaborated the importance of the organic cause of psychiatric symptoms as our patient initially presented with symptoms of depression. Regarding the diagnosis of meningiomas, nowadays excellent neuro-imaging methods are available, however, histological examination and immunohistochemistry remain the gold standard tools for a definite diagnosis. In our patient, the histological examination showed well-formed sinusoids and vascular channels which were consistent with the diagnosis of an angiomatous variant. Gross total resection of the lesion remains the treatment of choice with radiation therapy being used for residual tumors postoperatively. Being a type 1 variant, these meningiomas have a very small risk of recurrence. Here, we have presented a rare variant of meningioma initially presenting with prominent psychiatric symptoms of depression advancing to focal deficits.
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