Case Report: Neuro-ophthalmic manifestations of petroclival meningioma.

Abstract

Purpose: To describe the neuro-ophthalmic manifestations of petroclival meningioma including multiple cranial neuropathies (e.g., trigeminal (V), abducens (VI), facial (VII), vestibulocochlear (VIII), glossopharyngeal (IX), vagus (X), accessory (XI), and hypoglossal (XII) dysfunction).

Background: Petroclival meningiomas (PCM) are uncommon, benign skull base tumors that often present gradually but can lead to significant morbidity and mortality due to brainstem and lower cranial nerve involvement.

Case presentation: A 42-year-old woman presented with gradual and progressive neck pain, headaches, and dysphagia. Neuroimaging showed a large petroclival meningioma with secondary obstructive hydrocephalus. She underwent staged surgical resections with near-gross total tumor resection. The patient subsequently developed new cranial nerve VI and VIII deficits. We also include a patient perspective of her condition as a unique aspect of the evaluation of PCM.

Conclusion: PCM can present with multiple progressive cranial neuropathies due to tumor effects or as a consequence of surgical or radiation therapy. We believe that including a patient perspective in clinical reports might improve physician empathy and understanding of the patient's condition and course beyond the traditional evaluation and management paradigms for brain tumors including PCM.