TY - JOUR T1 - Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2018-228454 VL - 12 IS - 3 SP - e228454 AU - Cristiano Antunes AU - Rui Ramos AU - Maria João Machado AU - Miguel Afonso Filipe Y1 - 2019/03/01 UR - http://casereports.bmj.com/content/12/3/e228454.abstract N2 - Posterior fossa lesions may present with behavioural changes and/or progressive neurological deficit. Patients may have symptoms for long periods which may be attributed to other causes such as psychiatric diseases. We report a case of a 44-year-old woman with behavioural changes lasting for 5 years who lost her job, marriage and the guard of her sons. Latterly, she developed neurological deficit, hydrocephalus and intracranial hypertension. A giant left pontocerebellar angle mass was diagnosed. A retrosigmoid craniotomy was performed with total removal and cranial nerve function’s preservation. Histology revealed a grade I meningioma. The surgical approach for such huge lesions on pontocerebellar angle is controversial concerning patient’s positioning and surgical route. A brief revision is made. Since nowadays medical imaging is more easily accessible, it is mandatory to have a brain image in patients with behavioural changes and/or neurological deficit to exclude potential structural and curable causes such as in this case. ER -