A large occipital meningioma with minimal symptoms in a 40-year old female: a rare case report from Syria.

Introduction: Meningiomas, the most common primary intracranial tumors, are typically benign. They can cause significant challenges and neurological symptoms, particularly when affecting visual processing areas. Case presentation: A 40-year-old female with a 2-year history of chronic headaches, worsening recently and accompanied by right eye opacity, was admitted for neurosurgery. She had no prior neurological disorders or relevant family history. MRI revealed a 5 large sacral meningioma measuring (5 × 5 × 5) cm, which was fully resected. Post-surgery, the patient was stable and monitored, displaying awareness and stable biomarkers. Preventive antibiotics were started, and she was advised to maintain a 45-degree sitting position during recovery. Clinical discussion: Large occipital meningiomas can present minimal symptoms, emphasizing the need for advanced imaging like MRI and CT for accurate diagnosis, surgical planning, and effective multidisciplinary management to optimize patient outcomes. Individualized treatment plans are crucial for balancing risks and benefits in surgery while preserving neurological function. Conclusion: This case emphasizes how occipital meningiomas, while less common, significantly affect quality of life due to their visual processing role, sometimes remaining asymptomatic despite size, creating diagnostic challenges for clinicians.