Symptoma

Olfactory Groove Meningioma

Meningioma of Olfactory Groove

An olfactory groove meningioma is a rare benign tumor with a rather insidious course. Most common symptoms are anosmia, headaches, and visual disturbances, but a range of manifestations, both neurologic and psychiatric, has been described in a significant number of patients. Clinical suspicion towards intracranial neoplasms must be raised when longstanding signs are present, whereas confirmation is achieved through imaging studies, such as magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and MR spectroscopy.

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].

  • Wound Infection

    A wound infection also 5%, A subdural hygroma requiring a subdural-peritoneal shunt in 5%. Disturbance in mental function and personality changes when present preoperatively or transiently in the postoperative period usually recover completely. [meningiomas.org]

    Wound infection occurred in one patient (5%) and postoperative hematoma occurred in three patients (15%) [Table 4]. [mmj.eg.net]

  • Lymphadenopathy

    There was no significant lymphadenopathy. There was no dependent oedema. Naso-pharyngeal examination did not reveal any abnormality. Respiratory system and cardiovascular system did not reveal any abnormality. The liver and spleen were not palpable. [ijo.in]

  • Anosmia

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

    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]

    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]

    As a result, the olfactory tracts are displaced laterally and are compressed, leading to anosmia. The base of the frontal lobe is displaced superiorly and posteriorly. [mdmag.com]

  • 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]

  • Nasal Discharge

    Patient denied of any nasal discharge, epistaxis, visual impairment and any neurologic abnormalities. Family history was unremarkable. [file.scirp.org]

  • Pharyngitis

    Naso-pharyngeal examination did not reveal any abnormality. Respiratory system and cardiovascular system did not reveal any abnormality. The liver and spleen were not palpable. [ijo.in]

  • Epistaxis

    The nasal extent of these meningiomas is more often asymptomatic, although signs of sinus obstruction and epistaxis have been described. [ncbi.nlm.nih.gov]

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

    Rare cases are diagnosed secondary to the effects of local invasion in the paranasal sinuses and consist of nasal obstruction, epistaxis, spontaneous cerebrospinal fluid (CSF) leaks, or meningitis. [clinicalgate.com]

    Patient denied of any nasal discharge, epistaxis, visual impairment and any neurologic abnormalities. Family history was unremarkable. [file.scirp.org]

  • Psychiatric Symptoms

    In larger tumors, encroachment of the optic nerves can lead to papilledema and loss of visual acuity. 1 Correct diagnosis is often delayed because of longstanding psychiatric symptoms that lead to misdiagnosis and mistreatment. [mdmag.com]

    The anatomic location of the olfactory groove meningioma may cause prolonged psychiatric symptoms before the onset of more overt neurologic deficits. [operativeneurosurgery.com]

    The anatomic location of OGMs may cause prolonged psychiatric symptoms before the onset of more overt neurologic deficits. For these reasons, OGM are among the largest intracranial tumors we see [3]. [mmj.eg.net]

  • Flat Affect

    Occasionally, an early stage of aggressiveness has been reported. 11, 12 Exceptional cases of euphoria have also been described. 13 Patients then develop a flat affect as well as some short-term memory problems from subtle frontal lobe dysfunction. [clinicalgate.com]

    Physical and neurologic evaluations were remarkable for a flat affect, psychomotor retardation, and urinary incontinence. She was diagnosed with a major depressive episode, and inpatient medical treatment was started. [mdmag.com]

  • Olfactory Hallucination

    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 muscous membrane 嗅粘膜 olfactory nerve 嗅神经 olfactory nerve filament [医]嗅神经丝 olfactory [fastdict.net]

  • 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]

    Souza et al., 2003 [15] 27, M OGS Headache Yes Cystic Homogeneous n.r. [docslide.com.br]

    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]

  • 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]

    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]

    The triad of anosmia and unilateral optic atrophy with contralateral papilledema first described in the Foster Kennedy syndrome is rare and can be observed in other conditions. 16 – 19 In addition to the Foster Kennedy syndrome, optociliary shunting may [clinicalgate.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]

Morbidity and mortality associated with operative treatment of olfactory groove meningiomas have improved greatly over the past 3 decades. [memyselfmeningioma.wordpress.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]

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]

Prognosis Morbidity and mortality associated with operative treatment of olfactory groove meningiomas have improved greatly over the past 3 decades. [mdmag.com]

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]

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]

and by etiology (e.g. radiation-induced etc.). Typical meningiomas appear as dural-based masses isointense to grey matter on both T1 and T2 weighted imaging enhancing vividly on both MRI and CT. [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]

Prevention of hip fracture in elderly people with use of a hip protector. ‏ [books.google.com]

The region of the cribriform plate is covered with a graft of pericranial tissue and Gelfoam to prevent a cerebrospinal fluid (CSF) leak. [meningiomas.org]

The results indicate that problems in the affective appreciation of humour and in emotionalizing (alexithymic symptoms) may be the result of damage to the ventral-rostral portions of the ACG/mPFC, which prevent the patient from assessing the salience [operativeneurosurgery.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.