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Olfactory Meningioma in a 60-Year-Old Woman Presenting Depressive Symptoms and Atypical Visual Hallucinations

Author(s): Simone Marchini and Marie Delhaye

The authors describe a 60-year-old woman with depressive symptoms and visual hallucinations. The patient reported atypical visual hallucinations and typical severe depressive episode. Cerebral MRI showed a fronto-basal lesion measuring 67 mm x 62 mm x 51 mm with mass effect and perilesional oedema highly suspected olfactory meningioma. The atypical visual hallucinations and depressive symptoms were completely resolved after neurosurgery intervention on the fronto-basal olfactory meningioma. The Perception and Attention Deficit (PAD) model allows understanding of the double role of the olfactory meningioma of the 60 year old woman in the genesis of her recurrent complex visual hallucinations. The mass effect directly on the optic chiasm altered the sensory visual input and probably affected network areas between frontal and parietal cortex that are responsible of visual attention top-down signals functions. The authors conclude that the resolution of the atypical visual hallucinations after surgery was not accompanied by a complete resolution of cranial nerves dysfunction that persisted after months after intervention.

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