Magnetic Resonance Imaging and Angiographic Appearance of Meningioma of the Fourth Ventricle —Two Case Reports

• Published in: Neurologia medico-chirurgica Vol. 37; no. 1; pp. 36 - 40
• Main Authors: ISEDA, Tsutomu, GOYA, Tomokazu, NAKANO, Shinichi, WAKISAKA, Shinichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 1997
• Subjects: Aged; cerebral angiography; Cerebral Ventriculography; Female; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms - pathology; Meningioma - pathology; meningioma of the fourth ventricle; Middle Aged; Prognosis
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.37.36

A 47-year-old female presented with a transitional type meningioma entirely confined to the fourth ventricle. The tumor was totally resected. A 67-year-old female had undergone resection of an intraventricular transitional type meningioma of the fourth ventricle 9 years previously. She presented with a new meningioma of an obviously different origin at the posterior rim of the foramen magnum. The new meningioma was totally resected and the histological diagnosis was atypical meningioma. The magnetic resonance (MR) imaging characteristics of these two intraventricular meningiomas of the fourth ventricle were isointense and slightly hypointense to gray matter on the T1-weighted images, and hyperintense to gray matter on the T2-weighted images, with intense and homogeneous enhancement with gadolinium. Angiography showed the two intraventricular meningiomas fed by branches of the posterior inferior cerebellar arteries or superior cerebellar arteries. The second meningioma with dural attachment was fed by the right occipital artery. Intraventricular meningiomas of the fourth ventricle are not supplied by meningeal branches from vertebral and external cerebral arteries. MR imaging is the most useful tool in preoperative diagnosis, but cerebral angiography should also be performed to confirm the feeding vessels and the correct diagnosis.