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All Journal Paediatrica Indonesiana Neurologico Spinale Medico Chirurgico Muhammadiyah Journal of Geriatric Neurona Acta Neurologica Indonesia
Mohamad Saekhu
Departemen Bedah Saraf, Fakultas Kedokteran, Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Managing Elevated Intracranial Pressure as the Complication of Angiomatous Meningioma Adriana Damayanti; Tiara Aninditha; Henry Riyanto Sofyan; Irma Savitri; Rahmad Mulyadi; Mohamad Saekhu
Acta Neurologica Indonesia Vol. 3 No. 04 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i04.92

Abstract

Introduction: Meningioma is the most common central nervous system primary tumor, which can grow at the cranial base. Angiomatous meningioma, with a prevalence of 2.1%, is classified as the World Health Organization (WHO) grade I meningioma. Although considered benign, it has high Vascular Endothelial Growth Factor (VEGF) activity. Case Report: A 41-year-old woman presented with clear nasal discharge upon sitting, progressive headaches, blurred vision, and right-sided hemiparesis following prior surgeries for angiomatous meningioma. Initial symptoms included episodic headaches, later worsening with visual impairment and motor deficits. She underwent decompressive craniectomy, VP shunt placement for hydrocephalus, and cranioplasty but had a functional decline. Examination revealed decreased consciousness, anisocoria, right facial nerve palsy, spastic hemiparesis, and pressure ulcers. Imaging confirmed tumor progression with uncal herniation and hydrocephalus. After infection management, VP shunt revision improved her condition, and tumor resection was planned. The prognosis remained poor regarding survival, function, and recovery. Discussion: Although considered benign, it has high activity of Vascular Endothelial Growth Factor (VEGF). Massive peritumoral edema may lead to complications by increasing intracranial pressure (ICP). The management of elevated ICP includes tumor resection, cerebrospinal fluid (CSF) diversion, and administration of anti-edema agents. Due to its challenging access and proximity to vital structures such as cranial nerves and blood vessels, determining an appropriate management strategy poses a significant challenge to avoid disability. Conclusion: Skull base meningioma in women aged 40–70 poses a high risk of complications and disability if mismanaged, especially angiomatous meningioma with high vascularity despite being WHO Grade I.
Co-Authors A.A. Ketut Agung Cahyawan W Adriana Damayanti Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Al Rasyid Amelia, Ria Amir S. Madjid, Amir S. Anna Mira Lubis Aryandhito Widhi Nugroho Bismo Nugroho Bismo Nugroho PPR David Tandian Eka Susanto Eka Susanto Henry Riyanto Sofyan Hilman Mahyuddin Ina S. Timan Ina S. Timan, Ina S. Irma Savitri Jeremia Prasetya Pardede Jeremia Prastya Pardede Kevin Gunawan Kurniawan, Azhar Farisyabdi Kurniawan, Mohammad Mahyuddin, Hilman Martin Susanto Mohamad Sadikin Muhammad Harisyah Ninik Mudjihartini Nugroho, Setyo Widi Nugroho, Setyo Widi Nurhadi Ibrahim Padmo Santjojo Pangeran, David Putri, Stefanie Karina Rahmad Mulyadi Rahmana, Arizari Haj Rakhmad Hidayat Ray, Laode Maly Renindra A Aman Renindra A. Aman Renindra A. Aman Renindra Ananda Aman Ronokusumo, Teguh A.S. Ronokusumo, Tegus A.S. Sadewo, Wismaji Salim Harris, Salim Samsul Ashari Setyo Handryastuti Setyo W. Nugroho Sri Widia A.Jusman Sudigdo Sastroasmoro Syaiful Ichwan Taufik Mesiano Tiara Aninditha Tiara Aninditha Yulius Seno Nugroho