A Huge Bifrontal Meningioma Associated With Intraoperative Massive Bleeding

We report a 25-year-old Iranian female who presented with progressive memory disturbance, headache, and personality change associated with loss of visual acuity since 3 months before admission; bilateral optic atrophy was also noted. Magnetic resonance imaging disclosed a large bifrontal lesion accompanied by prominent edema in both frontal lobes. Cerebral angiography demonstrated a rich-vessel tumor that drained through the diploic vein. A bifrontal craniotomy was performed. We encountered massive bleeding from the diploic vein and dura mater immediately after craniotomy. We were also faced with severe brain swelling at the dural incision. The tumor was solid, highly vascularized, and fairly well demarcated. We performed total removal of the tumor as quickly as possible to reduce intracranial hypertension and avoid impending brain herniation. The patient had an uneventful recovery, and no new neurologic deficits were noted at follow-up.