Skip to main content
SpringerLink
Log in

It’s all in your head: sinus node dysfunction secondary to a sphenoid wing meningioma

Sekundäre Sinusknotendysfunktion verursacht durch ein Keilbeinmeningeom

  • Case Report
  • Published:
Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Abstract

Background

A 57-year-old man presented with recurrent episodes of dizziness, weakness of legs, and presyncope. The electrocardiogram showed a sinus bradycardia and recurrent sinus pauses.

Results

Cardiac evaluation revealed a normal left ventricular ejection fraction without ischemic, structural, or valvular heart disease. Pronounced limb weakness prompted neurological consultation. Cranial magnetic resonance imaging showed a large right-sided intracranial tumor adjacent to the medial sphenoid wing. Surgical removal of the tumor was accomplished successfully after application of a transient cardiac pacemaker, while decision upon permanent pacemaker implantation was postponed. Histopathology provided evidence of a meningothelial meningioma. Postoperative assessment displayed the absence of sinus node dysfunction after tumor removal.

Conclusion

Careful differential diagnostic assessment of patients with symptomatic bradycardias needs to rule out reversible causes before implantation of permanent devices.

Zusammenfassung

Hintergrund

Ein 57-jähriger Patient stellte sich mit wiederkehrendem Schwindel, Beinschwäche und Präsynkopen vor. Elektrokardiographisch zeigte sich eine Sinusbradykardie mit rezidivierenden Sinuspausen.

Ergebnisse

Die kardiologische Abklärung ergab eine normale linksventrikuläre Ejektionsfraktion ohne Anhalt für eine ischämische, strukturelle oder valvuläre Herzerkrankung. Aufgrund der Beinschwäche wurde ein kraniales Magnetresonanztomogramm veranlasst, das einen rechtsseitig gelegenen intrakraniellen Tumor in Nachbarschaft zum medialen Keilbeinflügel zeigte. Der Tumor konnte unter perioperativer Versorgung mit einem passageren Herzschrittmacher erfolgreich entfernt werden, die Entscheidung bezüglich eines permanenten Schrittmachersystems wurde zurückgestellt. Die histopathologische Analyse erbrachte die Diagnose eines meningothelialen Meningeoms. Postoperativ war keine Sinusknotendysfunktion mehr nachweisbar.

Schlussfolgerung

Bei unklaren symptomatischen Bradykardien ist eine sorgfältige differentialdiagnostische Abklärung wichtig, um reversible Ursachen vor Implantation permanenter Geräte auszuschließen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

References

  1. Whittle IR, Smith C, Navoo P, Collie D (2004) Meningiomas. Lancet 363:1535–1543

    Article  PubMed  Google Scholar 

  2. Freeman KP, Monlux AW, Heald D, Sealock MC (1985) Bradycardia associated with meningioma in a dog. J Am Vet Med Assoc 187:838–839

    CAS  PubMed  Google Scholar 

  3. Locatelli ER, Varghese JP, Shuaib A, Potolicchio SJ (1999) Cardiac asystole and bradycardia as a manifestation of left temporal lobe complex partial seizure. Ann Intern Med 130:581–583

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We are indebted to the patient who gave written informed consent for publication of the data.

Author information

Authors and Affiliations

  1. Department of Cardiology, Angiology and Pulmology, University of Heidelberg, Heidelberg, Germany

    R. Rivinius, F.F. Darche, D. Thomas MD, H.A. Katus MD & P.A. Schweizer MD

  2. Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany

    B. Campos MD & A. Unterberg MD

  3. Department of Neuropathology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany

    L. Schweizer MD

Authors
  1. R. Rivinius
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F.F. Darche
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Campos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Unterberg MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Schweizer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. Thomas MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H.A. Katus MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P.A. Schweizer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P.A. Schweizer MD.

Ethics declarations

Conflicts of interest

R. Rivinius, F.F. Darche, B. Campos, A. Unterberg, L. Schweizer, D. Thomas, H.A. Katus, and P.A. Schweizer state that there are no conflicts of interest.

This article does not contain studies on humans or animals.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rivinius, R., Darche, F., Campos, B. et al. It’s all in your head: sinus node dysfunction secondary to a sphenoid wing meningioma. Herzschr Elektrophys 26, 300–302 (2015). https://doi.org/10.1007/s00399-015-0380-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00399-015-0380-8

Keywords

Schlüsselwörter

Search

Navigation