Medial Cranial Fossa Meningioma Diagnosed as MixedAnxiety Disorder with Dissociative Symptoms and Vertigo

Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatricsymptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder withdissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient’s vertigo anddepersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety andimproved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a lefthemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsiblefor the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years) psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medicallyunexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient.