Systematic review of meningiomas revealed by spontaneous intracranial hemorrhage

Clinicopathological characteristics, results and resignation rate.

https://pubmed.ncbi.nlm.nih.gov/36738963/

Context :

Méningiomes are rarely revealed by an intracranial hemorrhage. Little data is available in the literature on the resaigation rate after a first hemorrhagic episode or on the risk factors for resaignement. The following study corresponds to a systematic review of the literature on the meningiomas revealed by an intracranial hemorrhage.

Methods:

We have retrospectively collected all the meningiomas revealed by a spontaneous intracranial hemorrhage published between January 1980 and December 2021. We reported the clinical-spathological characteristics of hemorrhagic meningiomas and estimated the resaignement rate and the period of occurrence.

Results :

92 Studies met all the inclusion criteria, corresponding to a total of 120 cases. The average age was 56.3 years, with 55% of women. The most frequent type of hemorrhage was the subdural hematoma (41%), followed by the intraparenchymal hematoma (37%), the sub-Arachnoid hemorrhage (18%) and the intraventricular hemorrhage (4%).

A location of meningioma in posterior or intraventricular pit and the occurrence of an intra-parenchymal hematoma were associated with poor post-operative evolution.

74% of patients who were not operated on during the first bleeding presented a new bleeding episode with a median period of 120 days . The resaignement was earlier in the event of subarachnoid or intraventricular hemorrhage and for meningiomas located in posterior pit.

Conclusions:

Intracranial hemorrhage is a rare presentation of meningiomas. The resaignement rate is high (74%) and premature (before 3 months for half of the cases). It is therefore preferable to operate the meningiomas revealed by a hemorrhage without delay.