PT  - JOURNAL ARTICLE
AU  - Cristiano Antunes
AU  - Rui Ramos
AU  - Maria João Machado
AU  - Miguel Afonso Filipe
TI  - Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment
AID  - 10.1136/bcr-2018-228454
DP  - 2019 Mar 01
TA  - BMJ Case Reports
PG  - e228454
VI  - 12
IP  - 3
4099  - http://casereports.bmj.com/content/12/3/e228454.short
4100  - http://casereports.bmj.com/content/12/3/e228454.full
SO  - BMJ Case Reports2019 Mar 01; 12
AB  - 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.