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].

• Soft Tissue Mass

  As an incidental finding of this MRI, a soft tissue mass in the olfactory groove was detected (2 cm x 8 mm). It was recommended that the MRI be repeated but with contrast. The contrast MRI was carried out on May 13, 2013. [eplabdigest.com]

• 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]

• Hypertension

  Dementia epilapsy, incontinence of urine and the presence of bilateral grasp reflex were, presumably due to involvement of the frontal lobes and partially to intracranial hypertension. [ijo.in]

  His past history was significant with very rare episodes of paroxysmal AF and hypertension. His past surgical history was significant for an extensive traumatic injury to the face. [eplabdigest.com]

  Intracranial hypertension or seizures are less common initial symptoms. The anatomic location of OGMs may cause prolonged psychiatric symptoms before the onset of more overt neurologic deficits. [mmj.eg.net]

• Fracture

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

  There are cases of meningiomas forming under a fracture, area of scarred dura or around a foreign body. • Patients with von Recklinghausen’s disease tend to develop multiple meningiomas at a young age. [pietromortini.com]

  In December 2009, he had been in a four-wheeler vehicular accident resulting in multiple facial fractures, requiring three surgical interventions for their correction and repair. [eplabdigest.com]

  The Incas appear to have practiced a procedure known as trepanation since the late Stone age, during the Middle Ages in Arabia from 936 to 1013 AD, Al-Zahrawi performed surgical treatments of head injuries, skull fractures, spinal injuries, hydrocephalus [wikivisually.com]

• Facial Numbness

  These tumors can also cause extensive cranial nerve findings, including facial weakness, hearing loss, swallowing difficulty, and facial numbness. Some of these symptoms may mimic the usual symptoms seen with acoustic neuromas. [nni.com.sg]

  These tumors can cause visual problems, loss of sensation in the face, or facial numbness. [brighamandwomens.org]

  […] of sight within field of vision, blindness, double vision Headaches Symptoms of posterior fossa meningioma Sharp pains in the face, facial numbness, and spasms of the facial muscles Loss of hearing Difficulty swallowing Trouble walking Symptoms of suprasellar [cancer.net]

  In addition, they can cause loss of sensation in the face, or facial numbness. [pietromortini.com]

  He subsequently had a large area of central midline facial numbness and lost his sense of smell. The accident did not result in any change to his vision. [eplabdigest.com]

• 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]

• 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]

• 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]

• Seizure

  General symptoms General symptoms from the tumor pressing on the brain or spinal cord: Seizures. Motor seizures, also called convulsions, are sudden involuntary movements of a person’s muscles. [cancer.net]

  In advanced stages of tumor development, the appearance of seizures is common, whereas hemiparesis is also observed in a number of sufferers. [symptoma.com]

  Although Galbraith was not experiencing seizures or other symptoms, as a precaution the neurologist prescribed an anti-seizure medication. [skullbaseinstitute.com]

  Eight weeks after surgery, and after anti-seizure meds for several weeks, I feel like my ole energetic self! [steadyhealth.com]

  Location - Sphenoid Ridge Common Symptoms - Eye-bulging, decreased vision, paralysis of eye movement, seizures, memory difficulty, personality change, headache. [neurosurgery.ucla.edu]

• 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]

• Neuralgia

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

  Petroclival tumors can compress the trigeminal nerve, resulting in sharp pain in the face (trigeminal neuralgia) or spasms of the facial muscles. [brighamandwomens.org]

  Petrous meningiomas can press on the trigeminal nerve, causing a condition called trigeminal neuralgia. Suprasellar meningioma arises from the base of the skull near the pituitary gland and the optic nerve. [hopkinsmedicine.org]

  Petrous meningiomas often press on the trigeminal nerve, causing a condition called trigeminal neuralgia. Their location makes them much more difficult to reach surgically. [medpagetoday.com]

• Vertigo

  Examinations for vertigo included MRI; it disclosed a right sided frontal tumour suspected to be an olfactory meningioma (fig 2 ). The vertigo was classified later as benign positional vertigo. [jnnp.bmj.com]

  […] bilateral Meningothelial Dead 6 F 35 Headaches/Visual lost bilateral Meningothelial Normal 7 F 66 Headaches bilateral Meningothelial Dead 8 F 71 Headaches unilateral Meningothelial Normal 9 F 52 Headaches unilateral Meningothelial Normal 10 M 67 Headaches/Vertigos [ajns.paans.org]

  Return to Top Acoustic Neuroma A 56-year-old man presented with progressive hearingloss and vertigo. The latter symptom was so severe thathe had to stop work as a contractor. [uhnj.org]

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.