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Worsening of underlying giant chordoid meningioma: case report A 37-year-old woman experienced worsening of her underlying giant chordoid meningioma following the administration of midazolam (for headache), and unspecified anaesthetics and unspecified sedatives (administered during caesarean section). The woman was admitted to the obstetrics and gynecology department for caesarean section at week 39 of gestation. The pregnancy was uneventful except for headaches, which intensified during the last months of pregnancy. In the early morning, she underwent the caesarean section under unspecified anaesthetics and unspecified sedatives [hypnosedatives], and delivered a healthy male neonate with APGAR score of ten. After the delivery, she reported to be fine, and also breastfed her baby. During early evening hours, she complained about increased pain in the frontal area. Therefore, she was administered a small dose of IV midazolam 30mg (approximately 6 hours after the procedure). However, about 4 hours after midazolam administration (about 10 hours after the procedure), she became stuporous with GCS score of 9–10. Examination showed dilated right pupil with no response to light. CT scan revealed a hyperdense right frontotemporal lesion with significant distortion of ventricular system and midline shift. A mass was noted at the temporal tip. Subsequently, she underwent a resection surgery, and the mass was completely removed. She was then sedated and placed on mechanical ventilation for 24 hours for the achievement of homeostasis. The postoperative period was uneventful. Based on histological and immunohistochemical studies of the resected lesion, a diagnosis of chordoid meningioma was made. Additionally, it was considered that the delivery procedure, anesthetics and sedatives including midazolam probably worsened the underlying giant chordoid meningioma by helping the tumour to increase in size and/or increasing the amount of peritumoral oedema. Bakar B, et al. Giant chordoid meningioma symptomatic immediately after pregnancy: Report of a rare case. Clinical Neuropathology 29: 163-168, No. 3, Jun 2010. Available 803518804 from: URL: http://doi.org/10.5414/npp29163

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