• Go Matsuoka, Seiichiro Eguchi, Bikei Ryu, Tadasuke Tominaga, Tatsuya Ishikawa, Koji Yamaguchi, and Takakazu Kawamata.
• Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: matsuoka.go@twmu.ac.jp.
• World Neurosurg. 2019 Apr 1; 124: 758075-80.

BackgroundWe came across a rare case of recurrent hemorrhage from a meningioma. Here, we describe this case and discuss the treatment strategies for recurrent hemorrhage from a meningioma using a literature review.Case DescriptionA 61-year-old woman with a history of 2 episodes of hemorrhage from a meningioma originating from the left falx cerebri presented to our outpatient clinic. She was asymptomatic, and magnetic resonance imaging revealed a small tumor along the falx cerebri. However, we decided to remove the hemorrhagic meningioma. No abnormal vascular structures were recognized on preoperative angiography and intraoperative evaluation. The tumor was easily removed along the falx cerebri (Simpson grade I). The pathologic diagnosis was transitional meningioma, World Health Organization grade I. The patient experienced no recurrence of tumor or hemorrhage for up to 15 months after surgery.ConclusionsThe incidence of repeated bleeding from meningiomas is very rare and is seldom reported because the mortality associated with hemorrhage in meningiomas is high (28%-50%). Immediate diagnosis and surgical treatment with both hematoma evacuation and tumor removal are crucial to avoid inadequate and delayed treatment that may cause mortality.Copyright © 2019 Elsevier Inc. All rights reserved.

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