A rare case of transient ischemic attacks and acute ischemic stroke from left intracranial arteries encased in meningioma. (P1.021)

OBJECTIVE: To report a rare case of transient ischemic attacks (TIA) and acute infarct secondary to compression of intracranial artery by meningioma. BACKGROUND: Meningioma is the most common extra-axial brain tumor in adults. The commonly involved areas include the suprasellar, temporobasal, sphenoidal wing or petroclivial regions causing various neurologic symptoms. Ischemic stroke and TIAs due to compression of intracranial carotid and middle cerebral artery is rare. DESIGN/METHODS: A 68 year-old right-handed female admitted to the hospital for evaluation of intermittent episodes of right hand clumsiness, right facial numbness and slurred speech for two weeks. The episodes usually lasted for about 30 minutes. The episode happened once every day to every few days. Neurological examination showed right facial weakness and mild dysarthria without any extremity weakness. MRI showed gadolinium homogenous enhancing mass at left planum, sphenoid clinoid and supraclinoid with dural tail which encased and narrowed the left internal carotid artery (ICA). MRI also showed areas of restricted diffusion in the left MCA territory. CT angiogram showed severe left ICA and MCA stenosis due to encasement by the extra-axial mass. The patient opted for medical management and was asymptomatic at her follow up visit. CONCLUSIONS: Compression of the intracranial blood vessel is a rare complication of meningioma which can result in TIAs and ischemic stroke. Disclosure: Dr. Tantikittichaikul has nothing to disclose. Dr. Laengvejkal has nothing to disclose. Dr. Eldokla has nothing to disclose. Dr. Kim has nothing to disclose.