A case of petrotentorial meningioma presented as an acute subdural hemorrhage

The authors report a rare case of petrotentorial meningioma presenting as acute subdural hematoma. A 60-year-old female was introduced to our hospital complaining of sudden headache and gait disturbance. CT and MRI demonstrated a petrotentorial tumor with a subdural hematoma in the posterior fossa. The tumor was enhanced intensively on MRI and showed the dural tail sign. The patient developed progressive impairment of consciousness along with hydrocephalus. After ventricular drainage, emergency intracranial decompression through hematoma evacuation and partial tumor resection was performed. One month later, she improved clinically and the tumor resected totally in the second craniotomy. Histological examination showed a meningothelial meningioma with high vascularity in part. She recovered uneventfully and was discharged on foot. We discussed the etiology of an acute subdural hematoma caused by intratumoral hemorrhage and reviewed past literatures.