Large Frontal Meningioma with Mass Effect and Increased Intracranial Pressure. Rabih Hage , MD Valérie Biousse , MD. 41-year-old man 3 month history of unusual headaches and progressive vision loss in both eyes ( visual acuity limited to light perception OD and 20/60 OS).
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Rabih Hage, MD
Valérie Biousse, MD
In the right eye, therewas no response to the V4e. The visualfieldisseverelyconstricted in the lefteye.
Bilateraloptic nerve edema consistent withchronicpapilledema , withsecondaryopticatrophy in the right eye (the right optic nerve isalready pale)
Water marks temporal to the swollen discs
Large intracranial mass (arrows) with mass effect on the right frontal lobe
T1-Weighted Brain MRI(withoutcontrast)
T1-isointense extra-axial mass with mass effect on the right frontal lobe
The mass effectisresponsible for right-to-leftfalcineherniation
Areas of T2 hyperintensitywithin the mass (arrow) suggestnecrosis or cystic changes
Severecerebraledema adjacent to the mass
Homogeneousenhancementof the extracranialmass aftercontrast administration, consistent with a meningioma
Large right frontal meningiomapresentingwithraisedintracranialpressure.
The papilledemahad been unrecognized for a few weeks and the diagnosiswasonly made at the stage of secondaryopticatrophywithirreversible, severevisualloss.