large frontal meningioma with mass effect and increased intracranial pressure n.
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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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large frontal meningioma with mass effect and increased intracranial pressure

Large Frontal Meningiomawith Mass Effect and IncreasedIntracranial Pressure

Rabih Hage, MD

Valérie Biousse, MD

slide2

41-year-old man

  • 3 monthhistory of unusualheadachesand progressive vision loss in botheyes(visualacuitylimitedto light perception OD and 20/60 OS)
goldmann visual field
Goldmann Visual Field

Lefteye

Figure 1

In the right eye, therewas no response to the V4e. The visualfieldisseverelyconstricted in the lefteye.

fundus photographs
Fundus Photographs

Right eye

Lefteye

Bilateraloptic nerve edema consistent withchronicpapilledema , withsecondaryopticatrophy in the right eye (the right optic nerve isalready pale)

Figure 2

fundus photographs1
Fundus Photographs

Right eye

Lefteye

Water marks temporal to the swollen discs

Figure 3

t1 weighted brain mri without contrast
T1-Weighted Brain MRI(withoutcontrast)

Axial

Sagittal

Figure 4

Large intracranial mass (arrows) with mass effect on the right frontal lobe

slide7

T1-Weighted Brain MRI(withoutcontrast)

Figure 5

T1-isointense extra-axial mass with mass effect on the right frontal lobe

t1 weighted brain mri without contrast1
T1-Weighted Brain MRI(withoutcontrast)

Figure 6

The mass effectisresponsible for right-to-leftfalcineherniation

t2 spin echo weighted brain mri
T2-Spin Echo WeightedBrainMRI

Figure 7

Areas of T2 hyperintensitywithin the mass (arrow) suggestnecrosis or cystic changes

flair axial brain mri
FLAIR Axial BrainMRI

Figure 8

Severecerebraledema adjacent to the mass

t1 weighted brain mri with contrast
T1-Weighted Brain MRI(withcontrast)

Axial

Coronal

Sagittal

Figure 9

Homogeneousenhancementof the extracranialmass aftercontrast administration, consistent with a meningioma

final diagnosis
Final Diagnosis

Large right frontal meningiomapresentingwithraisedintracranialpressure.

The papilledemahad been unrecognized for a few weeks and the diagnosiswasonly made at the stage of secondaryopticatrophywithirreversible, severevisualloss.

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