Sapporo Medical Journal

Abstract : — Background: Olfactory meningiomas are rare tumors originating from olfactory groove dura cells, accounting for a small percentage of intracranial meningiomas. They present with visual disturbances, olfactory dysfunction, and severe headaches. Diagnosis is made using MRI, showing well-defined masses with specific enhancement patterns. Multidisciplinary management involves surgical resection while preserving neurological function. We present a case of a giant olfactory meningioma complicated by a postoperative brain abscess, emphasizing the significance of timely recognition and treatment of infectious complications. Case Presentation: A 58-year-old male with worsening symptoms of severe headaches, visual and olfactory disturbances, and declining visual acuity was diagnosed with a giant olfactory meningioma. MRI revealed a large tumor in the olfactory groove, compressing surrounding structures. A multidisciplinary team planned a bifrontal craniotomy for maximal safe resection. Postoperatively, the patient developed fever, headaches, and confusion. Imaging confirmed a brain abscess at the surgical site, likely due to infection. Empiric antibiotics were initiated, and a stereotactic aspiration was performed, yielding Staphylococcus aureus growth. Antibiotics were adjusted accordingly, leading to gradual improvement in the patient's condition. Intravenous antibiotics were continued for two weeks, and close monitoring for treatment response and residual deficits was conducted.