Clinico-rariologic features and surgical treatment of fbone-invasive dominant hemispheric miningiomas - A report of 2 cases in young Nigerians

Background Convexity meningiomas are the commonest type of intracranial meningiomas. There are no previous reports on the clinico-radiologic profile of patients with bone-invasive non-sphenoidal calvarial meningiomas from South East Nigeria. Aim This is the report of two young Nigerians with convexity meningiomas. One had been mismanaged as a case of epilepsy for 4 years. Both cases had successful neurosurgical intervention. Methods The clinical features of the patients are presented with relevant results of investigations including neuroimaging studies. Careful literature search was made using library and internet sources. Results The first case is a 20- year old woman with a 4 -year history of jacksonian seizures affecting the right limbs, chronic headache and progressive visual loss. She had been managed unsuccessfully with both orthodox and traditional herbal remedies prior to being referred to the University of Nigeria Teaching Hospital Enugu. The second case is a 26- year old man with one year history of chronic headache and jacksonian seizures of the right face, arm and leg. Sensorium was unimpaired in both cases and neurological deficits were present. Both patients had cranial computerised tomograms showing bone- invasive convexity meningiomas. Successful medical/ neurosurgical management was instituted in both instances. Conclusion The paucity of neurological/neurosurgical services in Nigeria makes for mismanagement of several disorders amongst the populace. Convexity meningiomas may be heralded by focal epilepsy. Neuroimaging helps to confirm suspected cases and appropriate medical/surgical intervention reduces the risk of mortality/ severe morbidity.