title: It's all in your head: sinus node dysfunction secondary to a sphenoid wing meningioma.
abstract: BACKGROUND
  A 57-year-old man presented with recurrent episodes of dizziness, weakness of legs, and presyncope. The electrocardiogram showed a sinus bradycardia and recurrent sinus pauses.
  
  
  RESULTS
  Cardiac evaluation revealed a normal left ventricular ejection fraction without ischemic, structural, or valvular heart disease. Pronounced limb weakness prompted neurological consultation. Cranial magnetic resonance imaging showed a large right-sided intracranial tumor adjacent to the medial sphenoid wing. Surgical removal of the tumor was accomplished successfully after application of a transient cardiac pacemaker, while decision upon permanent pacemaker implantation was postponed. Histopathology provided evidence of a meningothelial meningioma. Postoperative assessment displayed the absence of sinus node dysfunction after tumor removal.
  
  
  CONCLUSIONS
  Careful differential diagnostic assessment of patients with symptomatic bradycardias needs to rule out reversible causes before implantation of permanent devices.
authors.affiliation: Department of Cardiology, Angiology and Pulmology, University of Heidelberg, Heidelberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Rivinius
authors.forename: F F
authors.initials: FF
authors.lastname: Darche
authors.forename: B
authors.initials: B
authors.lastname: Campos
authors.forename: A
authors.initials: A
authors.lastname: Unterberg
authors.forename: L
authors.initials: L
authors.lastname: Schweizer
authors.forename: D
authors.initials: D
authors.lastname: Thomas
authors.forename: H A
authors.initials: HA
authors.lastname: Katus
authors.forename: P A
authors.initials: PA
authors.lastname: Schweizer
mesh_terms: D000328:Adult; D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D008579:Meningioma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery; D016896:Treatment Outcome