Encompassing approximately 12% of all meningiomas in the base of the skull, an olfactory groove meningioma (OGM) arises from the arachnoidal cells located in the lamina cribrosa of the ethmoid bone and frontosphenoidal suture [1] [2] [3]. One of the most important features of OGM is its frequent delay in the diagnosis due to lack of clinical suspicion despite the presence of typical symptoms and up to 3 years may pass before the condition is recognized [3] [4] [5]. Anosmia and headaches are considered to be the primary signs [1] [2] [6], but they are often misdiagnosed as sinusitis, migraines or neuralgia [6]. Moreover, visual deficits (hypophthalmos, visual acuity impairment, and vision loss), nasal obstruction, hyposmia, epistaxis, and papilledema may be seen [3]. In up to a third of cases, psychiatric complaints in the form of disinhibition, psychosis, personality changes, confusion, or even cognitive decline (eg. memory loss) are noticed [1] [3] [5] [7]. In advanced stages of tumor development, the appearance of seizures is common, whereas hemiparesis is also observed in a number of sufferers [3]. For still unknown reasons, the majority of case studies in the literature have identified a significant predominance towards female gender [1] [3] [7].

• Pallor

  Visual impairment, including optic disc swelling and pallor, was found in 45% of our patients on clinical examination. [mmj.eg.net]

• Anosmia

  Anosmia and headaches are considered to be the primary signs, but they are often misdiagnosed as sinusitis, migraines or neuralgia. [symptoma.com]

  When following up one of these patients for a period of 24 months anosmia ipsilateral to the tumour was still present. The four patients with bilateral anosmia had a large bilateral tumour, whereas all others had a lateralised tumour (table). [jnnp.bmj.com]

  The patient had right-sided anosmia. Computed tomography and magnetic resonance imaging showed a lesion in the frontal lobe that was deviated to the right and attached to the olfactory groove. [ncbi.nlm.nih.gov]

  Fig 3 – The cells of the olfactory epithelium Clinical Relevance: Anosmia Anosmia is defined as the absence of the sense of smell. It can be temporary, permanent, progressive or congenital. [teachmeanatomy.info]

  His anosmia persisted and he had diplopia on looking down after the operation. The diplopia resolved after 6 months but the anosmia remained. He has since resumed work. Figure 1. [cfp.ca]

• Hyposmia

  Moreover, visual deficits (hypophthalmos, visual acuity impairment, and vision loss), nasal obstruction, hyposmia, epistaxis, and papilledema may be seen. [symptoma.com]

  Anosmia and hyposmia was present in 9 and 10 cases respectively. Visual disturbances was seen in 16 cases. Radiological bone changes in form of hyperostosis and bone erosion was seen in 14 cases. [journalijar.com]

  Subfrontal schwannoma without hyposmia – case report Neurol Med Chir (Tokyo) 2004 ; 44 : 591-594 [cross-ref] [38] Sato S., Toya S., Nakamura T., Ohtani M., Imanishi T., Kodaki K., and al. [em-consulte.com]

  Six patients had anosmia ipsilaterally to the tumour, four of them were completely anosmic, two had contralateral hyposmia or normosmia. [jnnp.bmj.com]

  The time frame noted from the development of initial symptoms to the time of diagnosis varies substantially between different series and has been reported to be up to 14 years. 9 Hyposmia or anosmia is one of the earliest presenting symptoms, but few [clinicalgate.com]

• Hypotension

  With careful pre-operative angiographic evaluation, reversible intra-operative external carotid occlusion, controlled hypotension, steroids, osmotic diuretics, and early control of nutrient arteries, the en bloc removal of a large bilateral olfactory [ncbi.nlm.nih.gov]

• Angiomatosis

  […] cx_subject=141991&cx_image_only_mode=off&cx_repo=mpv4_repo&cx_from_folder=92585 COBB Syndrome 06 août 2005 ( #CNS-SNC-BRAIN-CERVEAU. ) Cobb syndrome syndrome de COBB ( cutaneous vertebral medullary angiomatosis ) http://www.emedicine.com/derm/topic769 [irmresonance.over-blog.com]

• Aggressive Behavior

  behavior DDX - large hyper intense parasellar/clinoidal tumor with midline shift, edema, hydrocephalus hypo intense areas within a diffusely enhancing tumor = hypervascularity 1. meningioma 2. hemangiopericytoma less likely: mets, glioma, lymphoma, brain [quizlet.com]

  Although they are usually easily diagnosed and are typically benign with a low rate of recurrence following surgery, there are a large number of histological variants with variable imaging features and, in some instances, more aggressive biological behavior [radiopaedia.org]

  OG GoodChoi et al., 2009 [13] 39, F OGS Headache Yes Cystic Heterogeneous Involved Yes CP GoodDaglioglu et al., 2008 [14] 31, F OGS Headache, aggressive behavior Cystic Heterogeneous Yes Darie et al., 2010 28, F OECT Seizures Yes Solid Heterogeneous Involved [docslide.com.br]

• Olfactory Hallucination

  […] meningioma 嗅叶沟脑膜瘤 olfactory groove syndrome [医]嗅沟综合征 olfactory hair 嗅毛 olfactory hallucination [医]嗅幻觉,幻嗅 olfactory islands [医]嗅岛 olfactory knob 嗅小结 olfactory lobe 嗅叶 olfactory membrane [医]嗅膜 olfactory mucosa 嗅粘膜 olfactory mucosa membrane 嗅粘膜 olfactory [fastdict.net]

• Anger

  ATLAS IRM FACE 06 août 2005 ( #CNS-SNC-BRAIN-CERVEAU. ) ATLAS d 'IRM de la FACE université ANGERS http://www.med.univ-angers.fr/discipline/radiologie/CadresAtlasF.html HISTIOCYTOME MENINGES. 25 janvier 2006 ( #CNS-SNC-BRAIN-CERVEAU. ) http://www.urmc.rochester.edu [irmresonance.over-blog.com]

• Headache

  A 55-year-old woman presented with a longstanding history of headache and personality change. Preoperative imaging suggested an olfactory groove meningioma invading the posterior nasal space. [ncbi.nlm.nih.gov]

  Anosmia and headaches are considered to be the primary signs, but they are often misdiagnosed as sinusitis, migraines or neuralgia. [symptoma.com]

  Symptoms of convexity meningioma Seizures Headaches Focal neurological deficits. [cancer.net]

  Case Discussion A 69-year-old male presenting with headache for one week and diplopia. 2 public playlists includes this case Related Radiopaedia articles Meningioma Promoted articles (advertising) Case information rID: 8334 Published: 24th Jan 2010 Last [radiopaedia.org]

• Meningism

  D32.0 Benign neoplasm of cerebral meninges D32.1 Benign neoplasm of spinal meninges D32.9 Benign neoplasm of meninges, unspecified D33 Benign neoplasm of brain and other parts of central nervous system D33.0 Benign neoplasm of brain, supratentorial D33.1 [icd10data.com]

  The extent of the low frontal exposure facilitates the resection of the tumor by offering early access to its vascular supply (ethmoidal arteries and meningeal branches of the middle meningeal and ophthalmic arteries). [clinicalgate.com]

  MRI - fronto temporal dural based lesion abutting the sylvan fissure, attached to lateral aspect of sphenoid wing meningioma primary tumors: hemangiopericytoma, primary bone tumor met infeciton: abscess, subdural empyema, meningitis vascular: avm inflam [quizlet.com]

  MENINGIOMA FACT SHEET Meningiomas are tumors that originate from the meninges which are membrane-like structures that surround the brain and spinal cord. [skullbaseinstitute.com]

  Meningiomas are extra-axial tumors and represent the most common tumor of the meninges. [radiopaedia.org]

• Foster-Kennedy Syndrome

  Foster-kennedy syndrome in a case of olfactory-groove meningioma. Indian J Ophthalmol 1965;13:75-8 How to cite this URL: Markand O N, Chandrakar K L. Foster-kennedy syndrome in a case of olfactory-groove meningioma. [ijo.in]

  We believe that this patient with olfactory groove meningioma represents a rare case of Foster Kennedy syndrome and optociliary shunt vessels. [ncbi.nlm.nih.gov]

  Foster–Kennedy syndrome (also known as Gowers–Paton–Kennedy syndrome, Kennedy's phenomenon or Kennedy's syndrome ) is a constellation of findings associated with tumors of the frontal lobe. [1] Although Foster–Kennedy syndrome is equated with Kennedy [en.wikipedia.org]

  Just saying....since that's what I have to do Gadi Medical Student Foster-Kennedy's syndrome due to olfactory groove #Meningioma. pope Medical Student Remember, Foster-Kennedy Syndrome has a very specific set of findings. [app.figure1.com]

  When symptomatic, they can produce Foster Kennedy syndrome (anosmia, ipsilateral optic atrophy, contralateral papilledema), metal status change, urinary incontinence Histological variables follow WHO grading I to III (from low recurrence to high rates [radiologyinthai.blogspot.com]

• Apathy

  In contrast, depression and apathy (negative symptoms) have been linked to damage to the dorsal and lateral aspect of the frontal lobe. [mdmag.com]

  The slow progression of symptoms in many cases may be accompanied by apathy in these patients, which decreases the likelihood they will seek medical care. [clinicalgate.com]

  Location - Parafalcine (arising the meningeal layer between the hemispheres of the brain) Common Symptoms - Seizures, lower extremity weakness, headache, personality changes, dementia, increasing apathy, flattening of affect, unsteadiness, tremor. [neurosurgery.ucla.edu]

  Problems encountered are usually due to the following: Those caused by pressure on normal pituitary tissue so that it cannot deliver its normal production of hormones, e.g., general weakness and fatigue, apathy, pale complexion, loss of menstruation before [nni.com.sg]

  Compression of the underlying brain can give rise to focal or more generalized cerebral dysfunction, as evinced by focal weakness, dysphasia, apathy, and/or somnolence. [emedicine.medscape.com]

• Encephalopathy

  UID=0ZV0Q6K4&PageId=1&Sess=1472132 E D A M Encephalopathie Démyélinisante Aigue. [irmresonance.over-blog.com]

Given the slowly progressive and underrecognized nature of OGM, it is essential to perform a comprehensive and meticulous workup. Firstly, a detailed patient history that will assess the course and progression of symptoms should be obtained, followed by a thorough physical examination, with a particular emphasis on the neurological examination. However, olfactory testing frequently yields normal findings, thus the typical clinical picture might be absent [2]. To determine the underlying etiology (but also to plan the optimal therapeutic strategy), imaging studies need to be employed. Computed tomography (CT), although sometimes sufficient to make the diagnosis [5], has shown to be of limited use in the assessment of olfactory groove meningioma (particularly in the postoperative setting when patients are checked for tumor recurrence) [4]. For this reason, MRI (sometimes with gadolinium contrast enhancement) is the recommended study, showing an isointense or slightly hypointense signaling on T1-weighted studies and a hyperintense signal on T2-weighted studies compared to the cerebral cortex in the case of OGM [3] [8]. Because meningiomas have a wide differential diagnosis, additional exams, such as diffusion-weighted imaging, diffusion tensor imaging (DT), and MR spectroscopy are frequently used to further solidify the diagnosis [8].

Dramatic technological advancements have also been made in diagnostic and interventional radiology as well as in surgical and radiation treatments for meningiomas, such as incorporation of the following in the treatment armamentaria: endoscopy, various [books.google.com]

Treatment Available Depending on the tumor itself and your health, we consider several treatment approaches. If you have other medical conditions, we may take a conservative approach, such as frequent imaging and observation. [mountsinai.org]

Treatment The treatment decisions are often difficult. Prior to the development of CT and MRI and microsurgical techniques it was difficult to remove these tumors completely and the risks of surgery were very high. [pietromortini.com]

Surgical resection is the treatment of choice in most cases. [mdmag.com]

OBJECTIVE: We reviewed our series of olfactory groove meningiomas (OGMs) with the aim to relate the surgical approach with outcome and to define clinical and pathologic predictors of prognosis. [ncbi.nlm.nih.gov]

Tumor at the base of the frontal lobe produces inappropriate behavior, optic nerve atrophy on the side of the tumor, papilledema on the other side, and anosmia (Foster- Kennedy syndrome). [6] Treatment and prognosis [ edit ] The treatment, and therefore [en.wikipedia.org]

In this section: Definition | Symptoms | Diagnosis | Treatment | Prognosis MRI image showing a typical meningioma tumor A meningioma is a tumor that arises from a layer of tissue (the meninges) that covers the brain and spine. [neurosurgery.ucla.edu]

Posttreatment prognosis of patients with esthesioneuroblastoma. Journal of Neurosurgery, Vol. 113, Issue. 2, p. 340. CrossRef Google Scholar Paulino, Arnold C. Ahmed, Irfan M. Mai, Wei Y. and Teh, Bin S. 2009. [cambridge.org]

Prognosis Meningiomas are known to recur. Many factors relate to recurrence, the most important of which is the extent of the original removal. Complete resection including removal of the dural margin is associated with a low rate of recurrence. [pietromortini.com]

A case of acute, severe, remitting, symmetrical visual loss with cecocentral scotomas, initially thought to be of toxic etiology, proved to be due to a typical suprasellar meningioma originating in the olfactory groove. [ncbi.nlm.nih.gov]

To determine the underlying etiology (but also to plan the optimal therapeutic strategy), imaging studies need to be employed. [symptoma.com]

Etiology The etiology of meningiomas is still unclear but is thought to be multifactorial. [mdmag.com]

Meningiomas 371 Orbitosphenoid Meningiomas 379 Cavernous Sinus Meningiomas Conservative Surgical Management 389 Preoperative Embolization of Meningiomas 89 Neuroophthalmic Evaluations in Patients with Meningiomas 101 Meningioma Tumorigenesis An Overview of Etiologic [books.google.com]

They can also be classified according to location (e.g. spinal, intraosseous, intraventricular etc.), by histological variants (e.g. clear cell, rhabdoid etc.), and by etiology (e.g. radiation-induced etc.). [radiopaedia.org]

We reviewed the literature in order to establish the epidemiology of these tumors, from which there appear to be divergent profiles depending on tumor origin and histology. [ncbi.nlm.nih.gov]

Due to their unusual frequency, we review the literature in order to establish the epidemiological profile and pathogenesis of this kind of tumor. [em-consulte.com]

Classification Epidemiology The incidence of olfactory groove meningioma is approximately 8%–14% of all intracranial meningioma s 4). [operativeneurosurgery.com]

Dueo their unusual frequency, we review the literature in order tostablish the epidemiological profile and pathogenesis of this kindf tumor.. [docslide.com.br]

Pathophysiology: Meningiomas arise from meningothelial cap cells that are largely distributed through the arachnoid trabeculations. [drtbalu.co.in]

The bone flap is secure to the skull by leaving a sufficient ridge at its inferior surface to prevent necrosis or edema of the pericranial flap. 48 Sufficient inferior fixation is also necessary to prevent the bone flap from sinking in and providing an [clinicalgate.com]

To prevent the recurrence, infiltrated underlying bone needs to be removed but some surgeons prefer a conservative approach to prevent CSF rhinorrhea and adjacent vascular injury [3] [4], or sometimes if there is not enough surgical field, surgeons may [file.scirp.org]

Drilling of the cranial base does not seem necessary for preventing tumoral recurrence. [revistaneurocirugia.com]

1. Nakamura M, Struck M, Roser F, Vorkapic P, Samii M. Olfactory groove meningiomas: clinical outcome and recurrence rates after tumor removal through the frontolateral and bifrontal approach. Neurosurgery. 2007 May;60(5):844-852.
2. Welge-Luessen A, Temmel A, Quint C, Moll B, Wolf S, Hummel T. Olfactory function in patients with olfactory groove meningioma. J Neurol Neurosurg Psychiatry. 2001;70(2):218-221.
3. Pallini R, Fernandez E, Lauretti L, et al. Olfactory groove meningioma: report of 99 cases surgically treated at the Catholic University School of Medicine, Rome. World Neurosurg. 2015;83(2):219-231.e1-3.
4. Snyder WE, Shah MV, Weisberger EC, Campbell RL. Presentation and Patterns of Late Recurrence of Olfactory Groove Meningiomas. Skull base surgery. 2000;10(3):131-139.
5. Leo RJ, DuBois RL. A case of olfactory groove meningioma misdiagnosed as schizophrenia. J Clin Psychiatry. 2016;77(1):67-68.
6. Tsikoudas A, Martin-Hirsch DP. Olfactory groove meningiomas. Clin Otolaryngol Allied Sci. 1999;24(6):507-509.
7. Pepper JP, Hecht SL, Gebarski SS, Lin EM, Sullivan SE, Marentette LJ. Olfactory groove meningioma: discussion of clinical presentation and surgical outcomes following excision via the subcranial approach. Laryngoscope. 2011;121(11):2282-2289.
8. Tamrazi B, Shiroishi MS, Liu C-SJ. Advanced Imaging of Intracranial Meningiomas. Neurosurg Clin N Am. 2016;27(2):137-143.