ASSOCIATION OF AN AVM WITH AN ADJACENT IPSILATERAL MENINGIOMA: TWO CASE REPORTS

Objective: This is a case of a rare association between an arterio-venous malformation and an adjacent meningioma. The aim was to do an exhaustive literature review, discuss the different therapeutic modalities and the pathophysiologic mechanisms that can explain such an association.Case Presentations: A 44 years old patient, seen in our department for episodes of generalised tonic-clonic seizures, with a background of chronic headaches for the past two months. An angio-CT scan and an angio-MRI showed the presence of an AVM associated with an adjacent space occupying lesion. An indication for a concomitant resection by a left frontal craniotomy passing the midline was made. Histopathology came back in favour of a meningothelial and fibroblastic meningioma. The second case was a 37-year-old patient, seen for sudden onset of loss of consciousness preceded by a clinical picture of intracranial hypertension. The angio-CT scan showed an AVM Spetzler grade II and a calcified lesion of the falx cerebri suggestive of a meningioma was discovered intra-operatively.Conclusion: The coexistence of an AVM and a meningioma is rare and is only rarely described in literature. Certain authors maintain that it is pure coincidence; while others hypothesize that there might be a causal relationship between AVM and meningioma. In our first case where the meningioma, adjacent to the AVM, was diagnosed few years after the latter, the hypothesis that the vascular malformation had induced the development of a meningioma is more likely.