{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:54:10Z","timestamp":1783421650480,"version":"3.54.6"},"reference-count":7,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,28]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>Posterior fossa lesions may present with behavioural changes and\/or progressive neurological deficit. Patients may have symptoms for long periods which may be attributed to other causes such as psychiatric diseases. We report a case of a 44-year-old woman with behavioural changes lasting for 5\u2009years who lost her job, marriage and the guard of her sons. Latterly, she developed neurological deficit, hydrocephalus and intracranial hypertension. A giant left pontocerebellar angle mass was diagnosed. A retrosigmoid craniotomy was performed with total removal and cranial nerve function\u2019s preservation. Histology revealed a grade I meningioma. The surgical approach for such huge lesions on pontocerebellar angle is controversial concerning patient\u2019s positioning and surgical route. A brief revision is made. Since nowadays medical imaging is more easily accessible, it is mandatory to have a brain image in patients with behavioural changes and\/or neurological deficit to exclude potential structural and curable causes such as in this case.<\/jats:p>","DOI":"10.1136\/bcr-2018-228454","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T05:16:07Z","timestamp":1553145367000},"page":"e228454","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5517-8824","authenticated-orcid":false,"given":"Cristiano","family":"Antunes","sequence":"first","affiliation":[{"name":"Neurosurgery, Hospital de Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Ramos","sequence":"additional","affiliation":[{"name":"Neurosurgery, Hospital de Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jo\u00e3o","family":"Machado","sequence":"additional","affiliation":[{"name":"Neurosurgery, Hospital de Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Afonso","family":"Filipe","sequence":"additional","affiliation":[{"name":"Neurosurgery, Hospital de Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,20]]},"reference":[{"key":"2025082710223594000_12.3.e228454.1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.20.1.22"},{"key":"2025082710223594000_12.3.e228454.2","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.2217\/fon-2018-0006","article-title":"An overview of meningiomas","volume":"14","author":"Buerki","year":"2018","journal-title":"Future Oncol"},{"key":"2025082710223594000_12.3.e228454.3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/COC.0b013e31816fc920","article-title":"Meningiomas in 2009: controversies and future challenges","volume":"32","author":"Campbell","year":"2009","journal-title":"Am J Clin Oncol"},{"key":"2025082710223594000_12.3.e228454.4","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S0090-3019(83)80007-X","article-title":"Meningiomas of the posterior fossa","volume":"19","author":"Mart\u00ednez","year":"1983","journal-title":"Surg Neurol"},{"key":"2025082710223594000_12.3.e228454.5","doi-asserted-by":"crossref","first-page":"907","DOI":"10.3171\/2009.6.JNS09120","article-title":"A modified far-lateral approach for large or giant meningiomas of the posterior fossa","volume":"112","author":"Sanai","year":"2010","journal-title":"J Neurosurg"},{"key":"2025082710223594000_12.3.e228454.6","doi-asserted-by":"crossref","first-page":"905","DOI":"10.3171\/2009.7.JNS091000","article-title":"Giant meningiomas of the posterior fossa","volume":"112","author":"Samii","year":"2010","journal-title":"J Neurosurg"},{"key":"2025082710223594000_12.3.e228454.7","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/WCO.0b013e3282f1a043","article-title":"Cranial base approaches to inaccessible intracranial tumors","volume":"20","author":"Monfared","year":"2007","journal-title":"Curr Opin Neurol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:22:43Z","timestamp":1756315363000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,20]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2018-228454"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228454","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}