Papillary meningioma (PM) represents a very rare histological subtype, which may present with massive intracerebral hemorrhage. Gross total tumor resection results in a lower recurrence rate and mortality. A 69-year-old man had been experiencing headache for 6?months. After exacerbating right frontal headache, he was brought to the emergency room. His Glasgow Coma Scale (GCS) was 11/15 and he had a left-sided hemiparesis. A computed tomography brain scan revealed a massive right frontal intracerebral hematoma with transtentorial herniation. During right frontal craniotomy and blood clot evacuation, a fleshy, pigmented tissue was encountered. Histopathological findings were consistent with PM World Health Organization Grade III. Complete tumor resection, Simpson II was achieved with a second operation. The hemiparesis and GCS normalized subsequently. The diagnosis of PM relies largely on histopathology and is not commonly encountered preoperatively in emergency cases. Staged surgery in this case resulted in a good outcome.
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机译:乳头状脑膜瘤(PM)代表了一种非常罕见的组织学亚型,其可能存在大规模的脑内出血。总肿瘤切除术均导致复发率较低和死亡率。一名69岁的男子一直在遇到6个月的头痛。加剧右前头痛后,他被带到了急诊室。他的Glasgow Coma Scale(GCS)是11/15,他有一个左侧血管核分离。计算机断层扫描脑扫描显示出具有促进突变的巨大右前颅内血肿。在右前平滑肌肿瘤和血凝凝块疏散期间,遇到肉质,着色的组织。组织病理学发现与PM世界卫生组织第三级一致。完全肿瘤切除,辛普森II通过第二种操作实现。随后血逐和GCS归一化。 PM的诊断主要依赖于组织病理学,并且在紧急情况下术后并不常见。在这种情况下术前手术导致了良好的结果。
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