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Fulltext Complete paraparesis following resection of parasagittal meningioma: recovering function with an early intensive neurorehabilitation program

Mazlan M, Fauzi AA

Med J Malaysia, 2011 Oct;66(4):371-3.
PMID: 22299564 MyJurnal

Paraparesis can occur as a primary presentation of brain pathology at the motor strip along the parasagittal region. It could also occur as a neurological complication especially following resection of parasagittal meningioma with infiltration of the superior sagittal sinus (SSS). We report a case of a complete paraparesis immediately following resection of bilateral parasagittal meningioma with infiltration of the middle third of the SSS. A gradual improvement in neurological recovery and functional outcome was observed over a period of one year after undergoing an intensive neurorehabilitation program beginning from the acute inpatient phase post surgery.

Matched MeSH terms: Meningeal Neoplasms/surgery*
Hypoglossal nerve tumor: A rare primary extracranial meningioma of the neck

Zulkiflee AB, Prepageran N, Rahmat O, Jayalaskhmi P, Sharizal T

Ear Nose Throat J, 2012 Nov;91(11):E26-9.
PMID: 23288802

We report a case of primary extracranial meningioma arising from the hypoglossal nerve in a 54-year-old man who presented with a 9-month history of hoarseness and progressive dysphagia. He had also noticed that his tongue was deviated to the left and, as a result, he was having difficulty pronouncing words. Examination revealed fasciculation and muscle wasting on the left side of the tongue. Other cranial nerve functions were normal. Contrast-enhanced computed tomography detected a heterogeneous mass that had arisen above the bifurcation of the left common carotid artery and had extended to near the skull base. Transcervical excision of the tumor was performed, and histopathology identified it as a meningioma of the hypoglossal nerve. The patient recovered uneventfully, and he was without recurrence at more than 2 years of follow-up. A primary extracranial meningioma is extremely rare, and its presentation may be subtle. A thorough investigation is necessary to avoid fatal compressive symptoms.

Matched MeSH terms: Meningeal Neoplasms/surgery
Does Putting Back Hyperostotic Bone Flap in Meningioma Surgery Cause Tumor Recurrence? An Observational Prospective Study

Lau BL, Che Othman MI, Fathil MFMD, Liew DNS, Lim SS, Bujang MA, et al.

World Neurosurg, 2019 Jul;127:e497-e502.
PMID: 30926555 DOI: 10.1016/j.wneu.2019.03.183

BACKGROUND: Replacing the skull defect with synthetic materials for hyperostotic bone secondary to meningioma is recommended owing to the possibility of tumor invasion. In our institution, neurosurgeons have been putting back the refashioned hyperostotic bone flap after meningioma excision because of budget constraints. The aim of this study was to review the long-term meningioma recurrence rate in these patients.
METHODS: This was a nonrandomized, prospective observational study conducted from September 2011 to January 2015 on patients with intracranial convexity and parasagittal meningiomas. Preoperative computed tomography brain scans were obtained in all patients to confirm bony hyperostosis. Intraoperatively, part of the hyperostotic bone was sent for histopathologic examination. The rest of the bone flap was refashioned by drilling off the hyperostotic part. The bone flap was put back over the craniotomy site after soaking in distilled water. All patients were followed up for tumor recurrence.
RESULTS: The study included 34 patients with convexity or parasagittal meningioma World Health Organization grade I-II who underwent Simpson grade Ia and IIa excision. Median follow-up was 63.5 months (mean 64.9 ± 9.4 months). The hyperostotic bone flap showed presence of tumor in 35% of patients. There were 2 patients with parasagittal meningiomas after Simpson grade IIa resections who developed tumor recurrences.
CONCLUSIONS: Our study found that meningioma recurrence was unlikely when autologous cranioplasty was done with refashioned hyperostotic bone. This could be done in the same setting with meningioma excision. There was no recurrence in convexity meningiomas at mean 5-year follow-up.

Matched MeSH terms: Meningeal Neoplasms/surgery*
A parapharyngeal meningioma presenting as a neck mass and multiple cranial nerve palsies

Mohamad I, Abdullah B, Idris Z, Naik VR, Bhavaraju VM

Ceylon Med J, 2011 Jun;56(2):73-4.
PMID: 21789871
Matched MeSH terms: Meningeal Neoplasms/surgery