Hemichorea-Hemiballismus in a Patient With a Large Right Cerebellopontine Angle Meningioma: A Case Report

Abstract

Background and Importance: Movement disorders caused by meningiomas in the Cerebellopontine Angle (CPA) region are yet to be reported. This case report emphasizes the importance of careful imaging studies and examinations for patients presenting with movement disorders, even for benign tumors and less common etiologies. Case Presentation: A 45-year-old woman presented with irregular, involuntary, shortterm, transient, and unpredictable movements in the right upper and lower limbs since several months before, which conformed to the hemispheric pattern of the hemichoreahemiballismus type. Despite these issues, the main complaints of the patient were severe headaches, convulsions, blurred vision, and intermittent altered consciousness. Upon physical examination, abnormal movements of the right face and right upper and lower limbs were apparent. Dystonia was noted in the patient’s upper limbs. On brain MRI, a homogeneous mass 3.5 cm in diameter was found in the patient's right CPA, with compressive effects on the pons and medulla. The diagnosis of meningioma was made, and an excellent outcome was achieved following resection. Conclusion: Although meningiomas are usually considered benign tumors, they can, as noted in this case report, exert mechanical mass effects on adjacent structures following gradual enlargement. This can lead to various movement disorders, even in unusual locations. Hence, all patients with movement disorders must be examined thoroughly, with the neurological examination being of utmost importance. The present case itself illustrates the variety of causes and manifestations of movement disorders, particularly dystonia and hemiballismus secondary to benign meningioma, even in less common site