ISOLATED DEMENTIA IN 2 PATIENTS WITH POSTERIOR INTRAVENTRICULAR MENINGIOMAS

Although patients with brain lesions of neurosurgical interest may som etimes present with a cognitive profile very similar to a primary deme ntia, they usually have a history and/or a neurologic examination whic h alert the clinician. The occurrence of mass lesions with purely isol ated cognitive deterioration has been mainly reported for locations at the level of the frontal lobes. A potentially positive prognosis is a dvocated in these cases, in terms of even complete reversibility of th e mental impairment when surgical removal is feasible and successful. We report two rare cases of posterior intraventricular meningiomas pre senting with isolated cognitive and behavioural changes consistent wit h a frontal type dementia; the outcome was favourable in one patient, whereas the second one suffered from massive intracerebral bleeding du ring the neurosurgical removal and required prolonged hospitalization and subsequent intensive neurorehabilitative efforts. By comparing our cases with previously published decision-rules regarding neuroimaging in dementia, we suggest that criteria should be enlarged, especially those regarding the age of the subject and the time elapsed from the f irst signs of the cognitive deterioration.