All of us at a certain point in our lives have suffered from occasional blackouts, and must have ignored it as a sign of weakness or imbalance in our diet. A 21-year-old young man who was undergoing his training in the state police force came to CK Birla Hospitals – CMRI with the complaint of headache and gradual swelling on the left forehead. He was having occasional blackouts specially after running for 5 km. Being in the police force he had to run for 5-8 km everyday as this was part of his daily training activity as a police trainee. Previously he could complete the task without any hassle, but with time he found it very difficult to manage even 2km. He noticed a gradual swelling on the left side of his forehead which made him doubtful about his condition.
Soon he came to CMRI, where he was evaluated by Dr. Soumitro Roy and Dr. Sujoy Mukherjee. Under their supervision he was advised to undergo a CT scan along with a MRI which showed a well-defined space occupying lesion (SOL) on the left side of the frontal sinus of forehead. However, the dura of the brain was intact. This was a rare presentation as this lesion was there for almost 6 years. So provisionally the lesion was thought to be a benign one. The tumour had softtissue with calcified mass.
The surgical team of Dr. Mukherjee and Dr. Roy decided upon operation for complete removal of the tumour. Craniotomy was performed through Bicoronal approach. The soft and heavily calcified tumour which had well-defined margin was dissected out. He recovered well within 5 days after his surgery and there were no issues of visual disturbance, CSF leak or epistaxis (nose-bleeding). After the operation he had been reviewed twice which showed his progress. His operation was aesthetically done as when the hair grew back, the entire hairline area where the incision was made, healed well. As per the histopathology report, the tumour was classified as Psammomatous meningioma WHO Grade 1. It was an unusual occurrence in frontal sinus region because it is commonly found in spine.
In conclusion Dr. Sujoy Mukherjee, Consultant – Maxillofacial Surgeon at CK Birla Hospitals – CMRI said, “Psammomatous meningioma doesn’t occur very often in patients. Luckily it was histologically benign which eliminated some risk from the operation. We ensured that the patient gets completely cured after the surgery. Also, cosmetologically we kept in mind not to leave any scar or disfigurement post-surgery on his face or forehead. We are glad that our patient is doing extremely well without any complications so far.”
It is important to go for immediate check-ups when he/she is suffering from sudden bouts of headache, dizzy spells, and occasional blackouts. Dr. Soumitra Roy,Consultant – Department of Neuroscience, CK Birla Hospitals- CMRI suggests the following:
1. Consult with a doctor immediately
2. Go for blood test, blood pressure check-up, ECG, MRI, CT Scan as prescribed by the doctor
3. Discuss your medication and history of any medical condition with the physician
Authored by Dr. Sujoy Mukherjee, Consultant – Department of Oral and Maxillofacial Surgery, CK Birla Hospitals- CMRI and Dr. Soumitra Roy, Consultant – Department of Neuroscience, CK Birla Hospitals- CMRI