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% des patients n’ayant pas été opérés lors du premier saignement ont présenté un nouvel épisode de saignement avec un délai de survenu médian de 120 jours. Le resaignement était plus précoce en cas d’hémorragie sous-arachnoïdienne ou intraventriculaire et pour les méningiomes localisés en fosse postérieure.

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.