Abstract
BACKGROUND A purely intrasellar meningioma is extremely rare. All the intrasellar meningiomas reviewed in the literature presented with symptoms of hypopituitarism and/or visual disturbance. A case of intrasellar meningioma with a sudden onset of headache and diplopia, mimicking a pituitary apoplexy, is reported. CLINICAL PRESENTATION This 35-year-old man with a sudden onset of headache and double vision was admitted. Neuroimages suggested an intrasellar tumor. Although a pituitary adenoma was suspected from clinical symptoms, a meningioma was compatible with neuroradiologic findings. INTERVENTION Transsphenoidal and frontoorbito-zygomatic approaches were attempted for removal of the tumor. Pituitary apoplexy could not be proved at either operation. The histopathologic diagnosis of this tumor was a fibrous meningioma. CONCLUSION The meningeal tail sign on magnetic resonance images may be a key to diagnosing intrasellar meningiomas.
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