Hostname: page-component-77c89778f8-5wvtr Total loading time: 0 Render date: 2024-07-17T00:39:49.848Z Has data issue: false hasContentIssue false

Massive Cerebral Edema Associated with Meningioma

Published online by Cambridge University Press:  18 September 2015

Venkita Jagadha
Affiliation:
Division of Neuropathology, Department of Pathology, University of Toronto and Toronto General Hospital
John H.N. Deck*
Affiliation:
Division of Neuropathology, Department of Pathology, University of Toronto and Toronto General Hospital
*
Department of Pathology, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Cerebral edema is a well-known complication of malignant astrocytoma and metastatic brain tumour. Though far less frequent, the association of cerebral edema with meningioma is also recognized; this is unpredictable and sometimes out of proportion to tumour size. We describe three cases where the mass effect was due to severe edema, rather than the tumour itself and was responsible for a catastrophic clinical presentation. The mechanisms responsible for the development of severe edema with meningioma which have been previously proposed are reviewed. They include tumour size, location, histologic subtype, cellularity, mitotic activity, vascularity and the presence of excretory-secretory activity. None of these consistently correlate with cerebral edema. Our cases suggest that spontaneous hemorrhage into the tumour may be the common factor responsible for severe cerebral edema. It is stressed that though a decidedly rare complication, cerebral edema secondary to meningioma should be entertained in the differential diagnosis of acute neurologic deterioration of these patients.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1987

References

1.Russell, DS, Rubinstein, LJ. Pathology of tumours of the nervous system. Baltimore, Williams and Wilkins Co 1977; ed 4, p 361.Google Scholar
2.Challa, VR, Moody, DM, Marshall, RB, Kelly, DL Jr. The vascular component in meningiomas associated with severe cerebral edema. Neurosurg 1980; 7: 363368.CrossRefGoogle ScholarPubMed
3.Smith, HP, Challa, VR, Moody, DM, Kelly, DL Jr. Biological features of meningiomas that determine the production of cerebral edema. Neurosurg 1981;8:428433.CrossRefGoogle ScholarPubMed
4.Gilbert, JJ, Paulseth, JE, Coates, RK, Malott, D. Cerebral edema associated with meningiomas. Neurosurg 1983; 12: 599605.CrossRefGoogle ScholarPubMed
5.Phillipon, J, Foncin, JF, Grog, R, Srour, A, Poisson, M, Pertuiset, BF. Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurg 1984; 14: 295301.CrossRefGoogle Scholar
6.Vassilouthis, J, Ambrose, J. Computerized tomography scanning appearances of intracranial meningiomas. J Neurosurg 1979; 50: 320327.CrossRefGoogle ScholarPubMed
7.Fine, M, Brazis, P, Palacios, E, Neri, G. Computed tomography of sphenoid wing meningiomas: Tumour location related to distal edema. Surg Neurol 1980; 138: 385390.Google Scholar
8.Budka, H. Hyaline inclusions (Pseudopsammoma bodies) in meningiomas: Immunocytochemical demonstration of epithelial-like secretion of secretory component and immunoglobulins A and M. Acta Neuropath 1982; 56: 294298.CrossRefGoogle Scholar
9.Kepes, JJ. Meningiomas. Biology, Pathology and Differential Diagnosis. Masson Publishing USA, Inc. New York 1982; Chapter 15, pp 3233.Google Scholar