Meningioma encased ruptured paraophthalmic aneurysm: case report and review of the literature

•First case of bilateral aneurysm with ruptured aneurysm encased in meningioma.•Preoperative inspection of MRI for prominent flow voids is encouraged.•Asymptomatic meningioma encased aneurysms should be treated.•Location of meningioma is the strongest impact factor of patient outcome.•Arachnoid plane intactness is important for surgical outcomes.

The association of intracranial aneurysms with meningiomas is rare. We report the first case of a 52-year-old woman in which a ruptured aneurysm was encased within a meningioma and associated with a contralateral extradural aneurysm. A PubMed search of literature using the search words “aneurysm” and “meningioma,” was performed in order to compile previously reported cases, Only 5 cases reported to date of an aneurysm within a meningioma. Although a rare occurrence, this case suggests the possibility of asymptomatic ICA aneurysms located within sphenoid wing meningiomas. Recognition of this possibility may be prudent in order to avoid inadvertent vascular complications during meningioma resection.