Cystic Meningioma Complicated by Delayed Hemorrhage from a Pseudoaneurysm: Case Report

ABSTRACT

We report a case of delayed rupture of pseudoaneurysm after operation for meningionma. A 68-year-old female presented with mild headache and hemiparesis. Magnetic resonance imaging showed a cystic mass lesion with a solid component, which was attached to dura in the right frontal area. The mass was totally removed, and diagnosed to transitional type meningioma with histopathological examination. Postoperatively, almost of preoperative symptoms were impoved. About a month later, she developed sudden onset deterioration of mental state and hemiparesis. Computed tomography disclosed a large intracerebral hemorrhage at the site of the tumor bed. Emergency operation was performed. During the evacuation of hematoma, we found a ruptured pseudoaneurysm, and secured it with circumferential wrappig and clipping. The patient recovered well and became ambulatory. In case of delayed intracerebral hematoma at the postoperative site, a possibility of the rupture of pseudoaneurysm should be considered.