Maria Cecilia Ong-Lingan
We report a case of a 42 year old Filipino female teacher right handed with atypical meningioma and concomitant chronic subdural hematoma who presented with persistent headache associated with nausea, vomiting and sensitivity to light and loud noise. With a positive family history of migraine, no previous history of trauma, and unremarkable past medical history, patient was initially treated as a case of migraine type headache and was given Topiramate, Hydroxyzine, Flunnarizine and Metoclopramide, which did not provide relief of symptoms. Cranial MRI with gadolinium contrast showed a right parietal convexity extra axial mass with concomittant right frontotemporoparietal chronic subdural hematoma. Histopathologic examination revealed Atypical Meningioma WHO Grade II, positive for vimentin and EMA immunohistochemical staining. The mainstay treatment still for Atypical Meningioma with chronic subdural hematoma is evacuation of the hematoma followed by gross total resection of the said extra axial mass and adjuvant radiation therapy. Benign tumors such as meningioma rarely present with tumor related hemorrhages, but as seen from this case, subdural hematoma formation whether acute or chronic is a possibility.
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