Intracranial space-occupying lesion - Erler Zimmer

Intracranial space-occupying lesion - Erler Zimmer

Clinical History

A 56-year-old woman, experiencing intermittent headaches and vomiting for the past 6 months, was admitted to the hospital in a comatose state after a grand mal seizure and did not regain consciousness.

Pathology

The specimen, a coronal section of the brain, reveals lateral and downward compression caused by a right-sided expanding intracranial mass, likely a meningioma. The original mass is no longer present. The anterior face displays midline structure shift with subfalcine herniation* of the cingulate gyrus. The posterior face (see photo) exhibits hemorrhages of varying ages within the temporal lobe and pons, characteristic of supratentorial mass lesions. Ventricular asymmetry is also noted.

*In subfalcine (or cingulate) herniation, the innermost part of the frontal lobe is pushed under part of the falx cerebri, between the two hemispheres of the brain.

Further Information

Symptoms of a space-occupying meningioma in the cranial cavity arise from the mass pressing on the brain, causing atrophy and displacement of brain parenchyma. This leads to symptoms resulting from interruptions to cranial nerve functions, blood flow, and normal cerebral functions. General symptoms may include:

- Muscle seizures (e.g., myoclonic or tonic-clonic)- Sensory changes, such as alterations in vision, smell, and/or hearing without losing consciousness.
Symptoms and signs can vary depending on the tumor's location.