Extensive Intracranial Meningioma With Dehiscences: A Case Report

• Published in: Curēus (Palo Alto, CA) CA), 2024-01, Vol.16 (1), p.e51596
• Main Authors: Toader, Corneliu, Glavan, Luca-Andrei, Covache-Busuioc, Razvan-Adrian, Bratu, Bogdan-Gabriel, Costin, Horia-Petre, Corlatescu, Antonio-Daniel, Ciurea, Alexandru Vladimir
• Format: Article
• Language: English
• Subjects: Brain cancer; Case reports; Cerebrospinal fluid; Collaboration; Embolization; Hypertension; Interdisciplinary aspects; Intervention; Medical imaging; Neurosurgery; Patients; Severe acute respiratory syndrome; Tumors; Wound dehiscence
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.51596

This case report elucidates the clinical and surgical journey of a 62-year-old patient with a history of multiple comorbidities including a severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection, presenting with temporospatial disorientation, bradypsychia, and bradyphasia, without motor deficits, diagnosed with sarcomatous meningioma and skull lysis. Amidst the complexities of managing primary brain tumors, this report underscores the significance of thorough morphopathological examination, while considering patient demographics and tumor localization in assessing the nature of the neoplasm. It highlights meningiomas as predominantly benign yet stemming from monoclonal proliferation, with their occurrence influenced by genetic predispositions and environmental factors such as ionizing radiation exposure. The intricate case details multiple surgical interventions necessitated by complications such as wound dehiscence and cerebrospinal fluid leaks, managed successfully through a tailored neurosurgical approach and meticulous postoperative care. This narrative reinforces the pivotal role of interdisciplinary collaboration, with substantial contributions from radiology, anesthesiology, intensive care, cardiology, infectious disease, and rehabilitation medicine in achieving favorable outcomes. The discussion contextualizes the patient's condition within the broader neurosurgical literature, reflecting on the prognostic factors associated with giant meningiomas and the impact of factors like age and tumor location on resection outcomes. The case also delves into the efficacy of Gamma Knife radiosurgery in long-term tumor control, drawing on retrospective analyses. In conclusion, the case report advocates for a nuanced, individualized treatment, where the integration of multiple disciplines and responsive management of postoperative complications is critical to patient recovery. The successful resolution of this patient's condition exemplifies the quintessential nature of interdisciplinary collaboration and highlights the potential for optimizing neurosurgical protocols in the context of complex patient profiles.