Petrocival Meningioma

Case Report

Abstract

A 67-year-old lady, initals MW, presents with headaches for a year gradual onset but insidious progression associated with projectile vomiting 4 months ago. 2 months before presentation to our facility, she got left lower limb weakness that later progressed to the left upper limb. On examination, the patient had a Karnofsky performance score of 50 and muscle power was 3 on the left side with upper motor neuron features.

MRI brain ordered showed a right-sided petroclival meningioma. A wide dural-based lesion medial to the internal auditory meatus and extending long the clivus below the internal auditory meatus was appreciated. The lesion was extra-axial with a CSF cleft between it and the anterolateral brain stem. However brain stem edema was appreciated with displacement of the vertebrobasilar vasular complex.

A subtemporal craniotomy with anterior petrosectomy was used to achieve resection of the tumour. A relook surgery was done a week later to further debulk the tumour. Patient was discharged 10 days after the second surgery. Marked neurological improvement was noted.