Feasibility, acceptability, and preliminary impact of the WHO-Caregiver skill training (CST) in a low-income clinical setting: a mixed-methods evaluation.

Meningioma en plaque (MEP) is a subtype of meningioma characterized by aggressive local growth, firm adherence to adjacent cortex, and frequent presentation with seizures or progressive focal deficits. The appearance of MEP on contrasted images is fairly typical; however, on noncontrast CT scans, it may appear as an isodense or hyperdense extra-axial lentiform lesion, mimicking a subacute or chronic subdural hematoma (SDH). Historically, symptomatic lesions presumed to represent SDH were managed surgically, allowing prompt recognition of an underlying tumor at the time of evacuation. However, middle meningeal artery (MMA) embolization has emerged as an increasingly common treatment for nonacute SDH, most often as an adjunct to surgery but increasingly as a stand-alone or temporizing measure. Because this treatment pathway may be pursued without direct neurosurgical evaluation or tissue diagnosis, radiographic misidentification of MEP as SDH may delay definitive oncological management while exposing the lesion to an intervention that may complicate subsequent resection. This evolving practice introduces a new diagnostic pitfall: patients with unrecognized MEP may undergo embolization instead of definitive tumor resection. Herein, we present 2 illustrative cases of patients with MEP, misdiagnosed as SDHs and managed with MMA embolization, leading to delay in care and complicating their ultimate resection.