Neurosurgical treatment of sporadic meningioangiomatosis

Abstract

Intracranial meningioangiomatosis is a rare, benign, focal cortical disorder characterised by a proliferative process. There is often diagnostic confusion with meningiomas or low grade glioma. Potentially amenable to surgical cure, early recognition of this condition is key to avoiding unnecessary alternative therapies. We present here the first case of meningioangiomatosis diagnosed and treated microsurgically in Bosnia and Herzegovina. A 13-year-old boy, previously well and having no family history of note, presented with a 2-year history of intractable seizures unresponsive to medical therapy. There was associated headache but no focal neurological deficit. Brain MRI showed a cortical lesion located on the medial side of the dominant frontal lobe. An interhemispheric frontal approach through a key-hole craniotomy was used and total resection of the lesion was performed. Intraoperatively, the specimen was noted to be of firm consistency with well-demarcated edges and minimal vascularity. Light microscopy showed spindle-shaped cells proliferating in a fascicular pattern. Reticulin was abundant in these areas. In the background, multiple foci of sammoma bodies were noted. Conclusion The boy remained seizure-free and off antiepileptic medications postoperatively. There was no recurrence radiologically or clinically in the 20-month follow up period.