Case report: Mirror paraclinoid aneurysm associated with mirror clinoidal meningioma.

Introduction: Clinoidal meningiomas and paraclinoid aneurysms are individually uncommon, with the coexistence of mirror paraclinoid aneurysms and clinoidal meningiomas presenting an even rarer scenario. While the association between meningiomas and aneurysms is documented, the simultaneous presence of mirror lesions for both pathologies is not reported in the literature. Clinical presentation: We report a 62-year-old female with a three-month history of moderate bifrontal headaches. Magnetic Resonance Angiography (MRA) revealed mirror paraclinoid aneurysms, prompting surgical intervention. During the procedure, mirror clinoidal meningiomas were incidentally discovered. The left aneurysm was addressed first due to higher rupture risk, followed by the right aneurysm 3 months later. Both meningiomas were confirmed as Transitional Meningiomas (Grade 1; OMS, 2021). The aneurysms were successfully clipped, and the patient had an excellent postoperative outcome. Conclusion: This case represents a unique occurrence of mirror ophthalmic segment internal carotid artery aneurysms associated with mirror clinoidal meningiomas, a combination not previously reported. Despite the limitations of MRA in detecting small meningiomas, it remains a valuable non-invasive screening tool for neurovascular diseases. The case underscores the need for further research to elucidate the association between cerebral aneurysms and meningiomas.

Pseudotumor Cerebri Presenting Unilateral Papilledema Associated with Iron-deficiency Anemia

Pseudotumor cerebri is a relatively common pathology that is characterized by intracranial hypertension in the absence of mass lesions. It commonly affects young and obese women, and its presentation with visual loss and bilateral papilledema is well-described in the literature. We present a case of a 44-year-old, non-obese, female patient presenting with unilateral papilledema and iron-deficiency anemia. This case emphasizes this unusual presentation and the rare association with iron deficiency.

O pseudotumor cerebral é uma patologia relativamente comum, caracterizada pela hipertensão intracraniana na ausência de lesões causando efeito de massa. Frequentemente afeta mulheres jovens e obesas, e sua apresentação, com perda do campo visual e papiledema bilateral, é bem descrita na literatura. Nós apresentamos um caso de uma paciente de 44 anos, não obesa, com papiledema unilateral e anemia ferropriva. Esse caso destaca essa apresentação incomum e a rara associação com a deficiência de ferro.