EVOLUTION OF A LEFT HEMIPARESIS AFTER RIGHT FRONTO-PARIETAL PARASAGITTAL MENINGIOMA, COMPLICATED WITH SECONDARY JACKSONIAN TYPE CONVULSIVE CRISES – CASE PRESENTATION

Meningiomas are the most common intracranial tumor, accounting more than a third of all primary central nervous system (CNS) tumors. Most meningiomas are sporadic, but there are some risk factors associated with higher incidence, such as: obesity, alcoholism, radiotherapy, use of oral contraceptive pills, breast cancer. Some patients can be asymptomatic or can be found clinical findings that include: psychomotor asthenia (irritability, emotional lability, forgetfulness, behavioral changes), headaches, vomiting, seizures, upper motor neuron signs (hypertonia, hyperreflexia, pathological reflexes, contralateral hemiparesis or paralysis), cranial nerves impairment. The best radiological method to diagnose meningioma and the peritumoral edema is brain MRI with contrast. Small-sized or asymptomatic meningiomas need to be monitorized by regular brain CT or MRI scans. By the other hand, large-sized, symptomatic, or fast-growing meningiomas need neurosurgical removal. The recurrence rate of meningioma depends on the histological grade and degree of resection. Long term complications can lead to an impaired health-related quality of life, with an increased risk for anxiety and depression.We reported a case of a 63-year-old female patient known for having a right fronto-parietal parasagittal meningioma operated (with bone flap) in January 2024 (histopathological examination – fibrous meningioma), who presented two days after surgery headaches, dizziness, Jacksonian seizures and left hemiplegia. The patient is admitted in the Neuromuscular Rehabilitation Clinic Division of SCUBA presenting motor deficit – left hemiparesis, moderate locomotor and self-care dysfunction. During hospitalization, the patient was evaluated both clinically and functionally using evaluation scales (DRS, QoL, modified Rankin scale, GOS-E, FAC, ADL, Barthel) and paraclinical investigation (laboratory tests, head CT, lumbar spine MRI) in order to establish an appropriate rehabilitation program. Although the patient’s evolution immediately postoperative was limited by symptoms like headaches, dizziness, secondary Jacksonian type convulsive crises and left hemiparesis, with a complex rehabilitation program the patient’s evolution was favorable, with clinical and functional skills, gait pattern, coordination, control and balance improvement. The patient needs periodic follow-up visits, so that any potential complications or tumor recurrence can be detected.