{"id":2740,"date":"2010-02-13T19:37:41","date_gmt":"2010-02-14T00:37:41","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=2740"},"modified":"2013-08-16T00:09:35","modified_gmt":"2013-08-16T04:09:35","slug":"meningioma","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/02\/meningioma\/","title":{"rendered":"Meningioma"},"content":{"rendered":"
Pathophysiology<\/strong><\/p>\n 1)<\/strong> tumor of arachnoid cells of meninges 2)<\/strong> usually attached to dura 3)<\/strong> may invade skull but rarely invades brain tissue 4)<\/strong> found most commonly along dorsal surface of spinal cord, along sagittal sinus, over cerebral convexities, and at the cerebellar-pontine angle<\/p>\n Signs and Symptoms<\/strong><\/p>\n 1)<\/strong> occasionally, is asymptomatic and found incidentally 2)<\/strong> symptoms are generally caused by mass effect 3)<\/strong> focal seizures 4)<\/strong> focal neurologic findings 5)<\/strong> increased intracranial pressure 6)<\/strong> loss of smell (if located in frontal lobes) 7)<\/strong> visual defects of optic neuropathy in one eye and hemianopia in the other if located anterior to chiasm<\/p>\n Characteristic Test Findings<\/strong><\/p>\n <\/p>\n Radiology<\/em> – 1)<\/strong> well-circumscribed, intensely contrast-enhancing lesion on CT and MRI 2)<\/strong> “dural tail” of contrast streak may be seen on CT scan 3)<\/strong> commonly associated with hyperostosis of skull<\/p>\n Histology\/Gross Pathology<\/strong><\/p>\n 1)<\/strong> arises from meningothelial cells of arachnoid 2)<\/strong> most tumors are in intimate contact with dura 3)<\/strong> well-circumscribed tumors with whorls of spindle cells and psammoma bodies<\/p>\n Associated Conditions<\/strong><\/p>\n neurofibromatosis types 1 and 2<\/p>\n Inheritance\/Epidemiology<\/strong><\/p>\n 1)<\/strong> second most common primary brain neoplasm after astrocytoma 2)<\/strong> uncommon in children 3)<\/strong> rarely can be overtly malignant<\/p>\n Treatment<\/strong><\/p>\n 1)<\/strong> resection for cure, if possible 2)<\/strong> if not easily approached surgically, local external beam radiation, or gamma-knife radiation is used 3)<\/strong> if small and asymptomatic in an elderly patient, it can be observed with serial CT scans, as tumors are very slow growing<\/p>\n Tips for USMLE<\/strong><\/p>\n if brain tumor appears to be attached to the dura, think meningioma<\/p>\n