Meningioma

These are large, mostly benign tumors (rarely malignant forms - meningosarcoma). They most often occur at the age of 45, more often around women (2: 1). They often have hormone receptors, and there is also a significant coincidence with breast cancer. If they occur in childhood, type 2 neurofibromatosis should be considered. They represent about 15% of all intracranial tumors.

Meningeoma grows from arachnoidey (cobwebs),  dura mater grows secondarily. It creates hyperostosis on the bone and later destroys it. It is pushed into the brain by meningioma. The localization is most often on the convexity of the brain or on the cranial base (parasagittally in the anterior and middle pit), falx, clavicle wing, selar area, bridge angle, tentoria, foramen magnum. The first three sites form a group of superficial menigeomas. Near venous rafts, it tends to grow into them and obliterate them.

Forms:
 * 1) 'solitary'  meningomy;
 * 2) 'meningomatosis'  - multiple meningiomas.

Clinical picture
Symptoms are related to focal neurological findings and intracranial hypertension. The location of the tumor from which the symptoms originate is important.
 *  'Surface meningiomas'  are predominantly  focal symptoms  - hemi paresis, hemi hypoaesthesia, seizures;
 * cranial base meningiomas are characterized by disorders cranial nerves - in the front and middle pit cranial olfactory loss, visual disorders, eye movement disorders, in the posterior cranial pit  paresis] ] [[facial nerve, hearing disorders, tongue paresis;
 * when locating  'in the bridge of the' , imitates the symptoms of vestibular schwannoma;
 * oppression of cerebrospinal fluid leads to hydrocephalus, there is an increase in intracranial pressure;
 *  Frontal lobe  'meningioma'  is common  Organic Psychosyndrome  with jokes and inconvenience.

Diagnosis
The main importance in the diagnosis of meningioma is CT and especially MRI with a more detailed view. The tumor is rich in blood. After administration of the contrast agent, there is a homogeneous increase in density on CT and MRI. Furthermore, angiography is performed, by means of which embolization of the tumor supply vessels can also be performed. This reduces the risk of perioperative bleeding. In angiography, meningioma stains in the capillary phase - unlike gliomas, which stain in the arterial phase.
 * CT
 * MR
 * Angiography

Treatment

 * The basis is'  neurosurgical removal  - the entire tumor is removed, even with the infiltrated dura mater. The hard diaper defect is replaced by a plastic. The infiltrated bone is also removed and replaced with polymethyl methacrylate or titanium lattice. In some cases (cranial meningiomas) it is necessary to perform only partial removal and irradiate the rest of the tumor with a gamma knife.
 * Conventional irradiation is used for aggressive and malignant forms of meningiomas.
 * Recurrence depends on the radicality of the procedure, after complete resection about 10% of recurrences in 10 years.

Source

 * ws:Meningiomy

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