case_images: PMC11246846_01
case_images: (A) The basal pools, ring pools, tetrapodal pools, and lateral fissure pools were all visible as hyperdense shadows with a full brain parenchyma and flattened sulcus gyrus. The initial diagnoses were subarachnoid hemorrhage and brain swelling. (B) Dense shadows were present in the bilateral lateral fissure pools and in part of the left parietal sulcus, and the hemorrhagic portion had decreased in size.
case_images: fonc-14-1413610-g001.jpg
case_images: PMC11246846_01_fonc-14-1413610-g001.jpg
case_images: f1
case_images: Cranial CT ( Figure 1A ) revealed subarachnoid hemorrhage, which was considered a ruptured intracranial aneurysm. No intracranial tumor was detected on preoperative or postoperative cranial CT ( Figure 1B ).
case_images: (A, B) The right temporal lobe had an abnormal signal shadow similar to a circle. The shadow measured approximately 5.1 x 4.1 cm2 with a clear border, and the adjacent lateral ventricle was compressed and deformed, with a leftward deviation of the midline of approximately 0.5 cm. These findings were consistent with the manifestation of a tumor, and the lesion was considered more likely to be a meningioma.
case_images: fonc-14-1413610-g002.jpg
case_images: PMC11246846_01_fonc-14-1413610-g002.jpg
case_images: f2
case_images: Urgent cranial MRI and CT revealed a right temporal lobe occupancy with significant displacement of midline structures, brainstem compression, and deformation but no dilatation of the ventricular system, and no enhanced scan was performed ( Figures 2A, B ).
case_images: (A) The right side of the skull was partially missing, irregular flaky mixed density shadows were present in the right temporal lobe, and the ventricular system was narrowed by compression, with a leftward shift of the midline of approximately 0.5 cm. (B) The right side of the skull was partially missing, the hyperdense and isodense shadows in right temporal lobe were less dense than previously observed, the ventricular system was narrowed by compression, and the midline was shifted to the left by approximately 0.3 cm. (C) Partial absence of the right cranium centered in the midline. (D) The right side of the skull was partially missing, irregular flaky hypodense shadows were present in the right temporal lobe, and the ventricles were structurally sound and centered on the midline. (E) The right side of the skull was partially missing, the right temporal lobe had an irregular flaky hypodense shadow that was significantly less extensive than previously observed, and the ventricular system was fair and centered on the midline.
case_images: fonc-14-1413610-g003.jpg
case_images: PMC11246846_01_fonc-14-1413610-g003.jpg
case_images: f3
case_images: The patient's postoperative CT confirmed that the tumor had been completely resected, with no significant bleeding in the operative area ( Figure 3A ). Physical examination illustrated that the patient's GCS score was 12, the pupils were equal in size and sensitive to light reflexes, and muscle strength was grade 4 in the left limb and grade 5 in the right limb ( Figure 3B ). MRI revealed that the meningioma had been completely resected ( Figure 3C ). Follow-up CT 2 and 5 months after surgery revealed no residual or recurrent tumor ( Figures 3D, E ), and the patient was able to return to normal activities without epilepsy, visual and auditory disturbances, headaches, or other sequelae.
case_images: (Right temporal lobe) Meningothelial meningioma, WHO grade I. Vimentin (+), EMA: portion (+), GFAP (-), S-100 (-), Ki-67 (+).
case_images: fonc-14-1413610-g004.jpg
case_images: PMC11246846_01_fonc-14-1413610-g004.jpg
case_images: f4
case_images: Organization (WHO) grade I;  Figure 4 ]. On the fifth postoperative day, the patient developed fever, lumbar puncture suggested an intracranial pressure of 210 mmH2O, and the color of cerebrospinal fluid was slightly yellowish and turbid.