EROL OZAN, ERDEM DEVECİ, İsmet KIRKPINAR, ÖZKAN TEHLİ

Olfaktor oluk meningiyomuna bağlı frontal lob sendromu: Gözden geçirme

Frontal lob hasarında gözlenen davranışsal sendromlar, frontal lobu subkortikal yapılara bağlayan dorsolateral prefrontal devre, orbitofrontal devre ve anterior singulat devredeki zedelenmeye bağlıdır. Dorsolateral prefrontal devredeki hasar yürütücü işlev bozukluğu, orbitofrontal devredeki hasar dizinhibisyon ve dürtüsellik, anterior singulat devredeki hasar ise abuli (apati ve amotivasyon) ile sonuçlanır. Otuz dokuz yaşında, kadın, iki yıl önce ortaya çıkan koku alamama ve birkaç ay sonrasında eklenen baş ağrısı yanı sıra, 1.5 yıl önce beliren ve artarak süren; durgunluk, isteksizlik, halsizlik, ev işlerini yapamama, sürekli uzanma ve uyuma gereksinimi ve son dönemde eklenen bulanık görme ve bir kez olan uykuda idrar kaçırma yakınmaları nedeniyle kapsamlı olarak değerlendirildi. Anterior singulat sendrom ile uyumlu olan bu klinik görünümün ardında, büyük bir olfaktor oluk meningiyomu saptandı. Bu hastayla ilgili verilerden yola çıkarak frontal lob sendromunu ve meningiyomları, özellikle olfaktor oluk kökenli olanları gözden geçirdik.

Frontal lobe syndrome due to olfactory groove meningioma: A review

Behavioral syndromes observed with frontal lobe injury involve lesions of the circuits, connecting the frontal lobe to subcortical structures. Dorsolateral prefrontal circuit lesions result in executive function deficits, orbitofrontal circuit lesions result in disinhibition and impulsivity, and abulia (apathy and amotivation) occur with injury to the anterior cingulate circuit. Thirty-nine years-old female patient was evaluated in our outpaient clinic due to experiencing anosmia for the past two years and headache which appeared a few months after this complaint. In addition to these complaints, the patient reported apathy, anhedonia, lack of energy, inability to perform household chores and increased sleep need for the past 1.5 years. Lately, the patient also reported having blurred vision and had an incidence of urinary incontinence during sleep. The clinical presentation was compatible with anterior cingulate syndrome due to a large olfactory groove meningioma. Depending on the data, we were motivated to review the frontal lobe syndrome and meningiomas, especially the ones originating from the olfactory groove.

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