A Case of Frontal Meningioma Presenting as Frontal Lobe Syndrome

Abstract Inverted papilloma is an uncommon tumor mostly arising from the lateral wall of the nasal cavity and displays a benign but locally aggressive behavior. Intracranial extension is an extremely rare presentation of inverted papilloma. Extension occurs either as a benign lesion or due to malignant transformation. We report a case of concurrent inverted papilloma and squamous cell carcinoma presenting with epistaxis and recent-onset altered behavior and memory impairment. After literature review of similar cases having inverted papilloma with intracranial extension, we could identify a total of 12 cases, most of which were recurrences of a primary inverted papilloma that were resected before extension into the cranial cavity. Most cases were of extradural extension, and intradural spread resulted in poor prognosis on follow-up. Concurrent inverted papilloma and squamous cell carcinoma extending into the anterior cranial fossa and frontal lobe is a very rare clinical entity and can present as frontal lobe syndrome.

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Clinico-Pathological Correlations of the Frontal Lobe Syndrome: Results of a Large Brain Bank Study

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000430460 ◽

2015 ◽

Vol 40 (3-4) ◽

pp. 121-129

Author(s):

Welmoed A. Krudop ◽

Sjanne Bosman ◽

Jeroen J.G. Geurts ◽

Sietske A.M. Sikkes ◽

Nicolaas A. Verwey ◽

...

Keyword(s):

Frontal Lobe ◽

Grey Matter ◽

Pathological Changes ◽

Brain Bank ◽

Large Brain ◽

Cortical Pathology ◽

Brain Changes ◽

Subcortical Regions ◽

Frontal Lobe Syndrome ◽

First Time

Aims: A clinical frontal lobe syndrome (FLS) is generally attributed to functional or structural disturbances within frontal-subcortical circuits. We studied the distribution of pathological brain changes in FLS. Additionally, the prevalence of FLS among various disorders was studied. Methods: We systematically screened clinical files of donors to the Netherlands Brain Bank (n = 2,814) for FLS. A total of 262 FLS cases were identified, and the distribution of postmortem pathological changes within the frontal-subcortical circuits was extracted from their neuropathological reports. Results: In 244 out of 262 patients (93%), pathological changes within the frontal-subcortical circuits were found: 90 subjects (34%) with frontal cortical pathology and 18 (7%) with pathology restricted to subcortical grey matter nuclei, whereas 136 subjects (52%) showed both cortical and subcortical pathology. In 18 subjects (7%), no pathology was found in the examined areas. The prevalence of FLS was highest in frontal-temporal lobar degeneration, followed by progressive supranuclear palsy and vascular dementia [χ2(6, n = 1,561) = 222.64, p < 0.01]. Conclusion: In this large brain bank study, the distribution of pathological changes in subjects with FLS was shown to be frontal-subcortical for the first time. A minority of FLS cases had pathology in the subcortical regions only or no frontal pathology at all.

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Predicting progression in the late onset frontal lobe syndrome

International Psychogeriatrics ◽

10.1017/s1041610218001242 ◽

2018 ◽

Vol 31 (5) ◽

pp. 743-748 ◽

Cited By ~ 2

Author(s):

Flora T. Gossink ◽

Everard Vijverberg ◽

Welmoed Krudop ◽

Philip Scheltens ◽

Max L. Stek ◽

...

Keyword(s):

Frontal Lobe ◽

Clinical Symptoms ◽

Late Onset ◽

Clinical Syndrome ◽

Clinical Markers ◽

Neuropsychological Profile ◽

Stereotypical Behavior ◽

Executive Deficits ◽

Magnetic Resonance Imaging Mri ◽

Frontal Lobe Syndrome

ABSTRACTA late onset frontal lobe syndrome (LOF) refers to a clinical syndrome with apathy, disinhibition, or stereotypical behavior arising in middle or late adulthood. Diagnostics are challenging, and both clinicians and patients need reliable predictors of progression to improve clinical guidance. In this longitudinal multicenter and genetically screened prospective study, 137 LOF patients with frontal behavior (FBI score≥11) and/or stereotypical behavior (SRI≥10) were included. Progression was defined as institutionalization, death, or progression of frontal or temporal atrophy at magnetic resonance imaging (MRI) after two years of follow up. Absence of progression at MRI in addition to stable or improved Mini Mental State Examination and Frontal Assessment Battery scores after two years was indicative for non-progression. The presence of stereotypy and a neuropsychological profile with executive deficits at baseline were found to be predictive for progression, while a history and family history with psychiatric disorders were predictors for non-progression. The combination of these clinical markers had a predictive value of 80.4% (p < 0.05). In patients presenting with late onset behavioral symptoms, an appraisal of the rate of deterioration can be made by detailed mapping of clinical symptoms. Distinction of progressive discourses from non-progressive or treatable conditions is to be gained.

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