A case of meningioma presenting as stroke

Abstract

Background: Meningioma is a common intracranial tumor that accounts for 14 to 19% of all primary intracranial neoplasms. Over 90% are benign and confirmed by either histology or radiological studies. We report a case of meningioma mimicking a stroke with adult onset tonic clonic seizures.

Methods: The case records of a 47-year-old female at the University of Port Harcourt Teaching Hospital and a review of the literature utilizing Google and Pub Med search was utilized.

Results: A 47 year old housewife presented to the emergency room with a 17 hour history of repeated generalized seizures and a 6 hour history of left sided limb weakness. She had a 10-year history of recurrent adult onset seizures and had a transient ischaemic attack 2 years prior to presentation A clinical diagnosis of right hemispheric stroke with left hemiparesis and left facial nerve palsy was made. A brain computerized tomography (CT) scan revealed a meningioma and the patient was referred for surgery.

Conclusion: Strokes in developing countries like ours are sometimes managed without  radiological evaluation due to financial constraints. There is however, the possibility of missing out treatable causes and stroke mimics like meningioma. Stroke misdiagnosis due to meningioma is a rare clinical occurrence but the presence of adult onset seizures should raise the suspicion and prompt further evaluation.

Keywords: Meningiomas; Stroke Mimic; Seizures