[Deep sylvian meningioma: case report and review of the literature].

A case of intrasylvian meningioma is presented with some considerations to the clinical, radiological, and pathological features of the tumor. A 34-year-old Japanese woman, who had experienced several episodes of fainting attacks since 19 years old, was admitted to our hospital on March 22, 1983. Her plain skull roentgenogram showed abnormal calcification in her left fronto-temporal region. CT scan demonstrated clear-marginal high density mass in the left sylvian fissure which was homogeneously enhanced after administration of contrast medium. Left carotid angiogram showed intrasylvian mass with small tumor stain in late arterial phase, but external carotid artery had no concern with this tumor. On March 30, left fronto-temporal craniotomy was performed. The tumor was located in the extra-axial space of the sylvian fissure without any attachment to the dura mater or to the choroid plexus of the ventricles. This hard tumor, 70 grams in its weight, was successfully removed. It was histologically diagnosed fibroblastic meningioma. The patient was discharged without any neurological deficits. Twenty-four cases of meningiomas not attached to the dura mater or to choroid plexus could be reviewed from the literature. This type of meningioma is occasionally called "deep sylvian meningioma", but in some reports the tumors developed far from sylvian fissure. And even in the cases in which the tumors were reported to be located in the sylvian fissure, macroscopic space where tumors developed was various. The clinical features, diagnosis, and surgical management of this tumor were also discussed in the report.