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Abstract: The patient was admitted to the hospital with the chief complaint of “headache for 1 week and 2 seizures”. The patient was initially diagnosed as a pars falciparum meningioma. The patient recovered well after the operation, with no headache or seizure, and the patient and her family were satisfied.
Basic information】Female, 58 years old
Disease Type】Parietal meningioma
Hospital】Liaoning Provincial People’s Hospital
Date of consultation】January 2022
Treatment plan】Surgical treatment (craniotomy for parafollicular meningioma) + drug treatment (Olacitant capsules, sodium valproate tablets)
Treatment period】Inpatient treatment for 14 days, 1 month of outpatient follow-up
Treatment effect: complete resection of tumor, no headache and seizure
I. Initial consultation
The patient was admitted to our hospital with the complaints of “headache for 1 week and 2 seizures”. 1 week before admission, the patient had headache with dizziness without any cause. The patient was initially diagnosed as a pars falciparum meningioma and was admitted to the hospital. After admission, the examination of cerebral arteries and veins was completed, and no abnormality was found.
II. Treatment history
After admission, the patient and his family were informed that the epilepsy was related to this tumor, and that most of these meningiomas were benign tumors, and that the patient’s images were basically benign, so they should not be overly anxious. After completing all the tests, the patient underwent a right-sided craniotomy under general anesthesia to remove the pars falciformis meningioma, and the operation went smoothly. After the operation, the patient was given olacitant capsules for neurotropic treatment and sodium valproate tablets for antiepileptic treatment.
III. Treatment results
After surgery, the patient recovered well, with clear speech and limb movement, and no seizure occurred. Postoperative review of head CT: no intracranial hemorrhage and no tumor in the original meningioma area. The patient recovered well after symptomatic treatment and removal of stitches, no dizziness and headache, no seizures, and his diet and sleep were significantly better than before admission. The patient was discharged from the hospital after 14 days of inpatient treatment, and was followed up in an outpatient clinic for 1 month. At the time of follow-up, the patient did not have any more epilepsy and was satisfied with the surgical result. The patient’s pathology also returned benign tumor, so radiotherapy was not required. The patient and family were very satisfied with the results.
IV. Notes
We are glad that the patient’s symptoms have improved after treatment, but since this patient was admitted mainly with epilepsy as the first symptom, it is necessary to continue oral treatment with sodium valproate tablets antiepileptic drugs for a period of time before stopping them after discharge, and it is necessary to follow the doctor’s prescription. Secondly, patients with parietal meningioma are often weak after surgery, so it is recommended to continue to eat more high-protein and high-calorie foods that can quickly replenish the nutrients needed by the body, such as beans, meat, fish, eggs and other foods, and to pay attention to the combination of diet. Finally, you should also pay attention to quit smoking and alcohol.
V. Personal insight
Because pars plana meningioma grows slowly, the tumor has already grown for several years or even more than ten years when the patient is seen, so the patient does not need to panic and often has to be anxious for surgery after admission. Most patients with parafollicular meningioma come to the hospital with headache and epilepsy as the first symptom. This patient comes to the hospital for seizures, and because of the location and size of the tumor, others come to the hospital with symptoms such as poor vision, poor hearing, or limb paralysis. In recent years, as people pay more attention to their health, the number of patients with parametrial meningioma detected by physical examination is gradually increasing, and early detection and early treatment are really achieved. All in all, it is necessary to go to the hospital for examination when there are uncomfortable symptoms.