Giant Meningioma Diagnosis and Clinical Treatment: A Case Report.

Autor:	Valerio J; Neurological Surgery, Palmetto General Hospital, Hialeah, USA.; Neurological Surgery, Larkin Community Hospital, Miami, USA., Santiago N; Neurological Surgery, Latinoamerica Valerio Foundation, Weston, USA., Fernandez Gomez MP; Neurological Surgery, Latinoamerica Valerio Foundation, Weston, USA., Rey Martinez L; Pathology and Laboratory Medicine, Palmetto General Hospital, Hialeah, USA., Alvarez-Pinzon AM; I-Health Institute, Florida Atlantic University (FAU) Charles E. Schmidt College of Medicine, Boca Raton, USA.; Cancer Neuroscience Program, Institute of Neuroscience of Castilla y León, University of Salamanca, Salamanca, ESP.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Aug 16; Vol. 16 (8), pp. e67029. Date of Electronic Publication: 2024 Aug 16 (Print Publication: 2024).
DOI:	10.7759/cureus.67029
Abstrakt:	This case report shows the importance of semiology during a clinical examination not only to diagnose spine clinical symptoms but also to review the central nervous system tumor as a foot drop cause. We report a unique case of a patient who consulted for constant progressive numbness and motor symptoms in the right lower extremity. Lumbar CT and MRI were negative for acute or chronic lumbar pathology. This is a 41-year-old female patient with a history of eight-month progressive right leg weakness. The physical examination did not reveal neurological alterations besides foot drop. MRI and lumbar X-rays showed no significant findings. Electromyography (EMG) indicated right peroneal neuropathy. Based on these findings, surgical treatment was not indicated; therefore, physical therapy and a referral to neurology were indicated. However, symptoms increased, resulting in a right lower extremity hemiparesis. A brain MRI showed a left frontoparietal giant meningioma, which was surgically resected after embolization. The patient evolved with a full recovery of the right-sided hemiparesis after surgery. Our case highlights the foot drop's multiple etiologies. Initially, a lumbar disc hernia was suspected, but it was ruled out by imaging studies. Later, the EMG revealed peroneal neuropathy, leading to a neurology consult. Unexpectedly, a giant intracranial meningioma was found, a rare case of foot drop. A consideration of upper motor neuron (UMN) and lower motor neuron (LMN) syndromes aided diagnosis. Tumoral resection with embolization resulted in significant improvement, showcasing the complexities of such cases. Foot drop is a peculiar clinical manifestation that must have an integral assessment to rule out peripheral and central causes. Even rare, giant meningiomas can cause focalized symptoms such as foot drop. Therefore, the assessment of foot drop should include the CT and MRI of the central nervous system. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Institutional Review Board of Larkin Community Hospital issued approval LCH-8-062021. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Valerio et al.)
Databáze:	MEDLINE
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