Multiple Cerebral Aneurysms and Subacute-Subdural Hematoma Coexistence With Multiple Meningiomas: A Case Report

摘要

Multiple aneurysms and multiple meningiomas co-existance can be seen rarely. Subarachnoid hemorrhage and subacute subdural hematoma coexistance in the same case is very rare. The female patient, at the age of 52, was hospitalized through emergency service with temporary blackout and severe headache complaints. There were no signs of trauma seen during her physical examination. Neck stiffness was positive. The patient's Glasgow Coma Scale score was 15. Right fron-toparietal subacute subdural hematoma and subarachnoid hemorrhage were determined with computerized brain tomography. Contrast enhanced magnetic resonance imaging showed two lesions which were sized 1.5x0.5 cm and 2.5x2.0 cm in the left occipital lobe. Bilateral middle cerebral artery (MCA) bifurcation aneuryms were determined at cerebral angiography. Bilateral MCA bifurcation aneurysm clippage and total excision of both tumoral lesions were done in the same operation with bilateral pterional and left occipital craniotomy. Pathological investigation of the tumoral lesions were reported as meningioma. The postoperative stage was uneventful. The patient's neurological examination was intact without any neurological deficit. Multiple cerebral aneurysms and multiple meningiomas coexistance can be seen rarely in the course of some connective tissue diseases and neurofibromatosis. In this report we present a case of multiple aneurysms and meningiomas without connective tissue disease or neurofibromatosis. The patient was treated succesfully by different surgical approaches in the same session.