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Parasagittal Meningioma


Presentation

  • With so few reported cases of intracranial involvement, more experience will be necessary before this clinical presentation and prognosis can be clearly outlined.[ncbi.nlm.nih.gov]
Hodgkin Lymphoma
  • Primary non-Hodgkin's lymphoma (NHL) of the skull with extra- and intracranial extension without systemic or skeletal manifestation in a non-immunocompromised patient is extremely rare.[ncbi.nlm.nih.gov]
Italian
  • Italian. PubMed PMID: 14018897. 60: ROVIT RL, BARONE BM, ETHIER R. Multiple primary intracranial tumors. (The development of a craniopharyngioma seventeen years after total removal of a parasagittal meningioma).[operativeneurosurgery.com]
Cervical Lymphadenopathy
  • It usually presents with bilateral painless cervical lymphadenopathy. In extremely rare circumstances, the CNS can be affected. Only 21 prior cases of intracranial involvement have been reported.[ncbi.nlm.nih.gov]
Aspiration
  • Prompt central venous blood aspiration, aggressive resuscitation and inotropic support managed to stabilize the patient. Post operatively, he was admitted in neuro intensive care unit and made a good recovery without serious complications.[ncbi.nlm.nih.gov]
  • During the separation process, the peritumoral normal brain tissue and the cerebral pia mater must be effectively protected, and the aspiration method, which may damage the central gyri, must not be performed ( 12 – 14 ).[spandidos-publications.com]
  • The tumor is debulked with an ultrasonic aspirator, and the capsule is separated from the cerebral cortex. The pial plane is maintained, and utmost attention is paid to preserving the cortical veins.[slideshare.net]
Progressive Dysphagia
  • In case 2, a previously well 83-year-old woman presented with a one-week history of progressive dysphagia and dysphasia. She suffered rapid deterioration and was prescribed comfort care.[ncbi.nlm.nih.gov]
Hypotension
  • VAE was provisionally diagnosed by sudden decreased in the end tidal carbon dioxide pressure from 34 to 18 mmHg, followed by marked hypotension and atrial fibrillation.[ncbi.nlm.nih.gov]
  • Bitahl PK, Pandia MP, Dash HH, Chouhan RS, Mohanty B, et al. (2004) Comparative incidence of venous air embolism and associated hypotension in adults and children operated for neurosurgery in the sitting position. Eur J Anaesthesiol 21(7): 517-522.[medcraveonline.com]
Retinal Hemorrhage
  • [Retinal hemorrhage, 1st symptom of a parasagittal meningioma]. Rev Otoneuroophtalmol. 1957;29(7):426-7. French. PubMed PMID: 13528399. 67: HOESSLY GF, OLIVECRONA H. Report on 280 cases of verified parasagittal meningioma.[operativeneurosurgery.com]
Skin Ulcer
  • .  Rarely, tumors may present with significant hyperostosis or skin ulceration, necessitating surgical intervention for cosmesis and/or reducing the risk of infections.  Meningiomas associated with significant peritumoral edema may also carry an increased[slideshare.net]
Subcutaneous Mass
  • [Malignant parasagittal meningioma appearing as a large subcutaneous mass]. No Shinkei Geka. 1994 Aug;22(8):785-8. Japanese. PubMed PMID: 8072639. 38: Nakasu Y, Takeichi Y, Nakasu S, Handa J.[operativeneurosurgery.com]
Scalp Mass
  • Neurosurgeons must maintain a broad differential diagnosis in any patient with a scalp mass eroding through the skull and associated neurological symptoms or signs.[ncbi.nlm.nih.gov]
Hyperreflexia
  • Cranial nerve, motor, and sensory examination did not show focal deficit, with the exception of mild hyperreflexia of the right upper and lower extremities compared with the left side.[ajnr.org]
  • Her neurological examination was normal, except for a positive Babinski sign on the left and hyperreflexia in both lower extremities.[hoajonline.com]
  • Compression of the underlying parenchyma may give rise to pyramidal signs that are exemplified by pronator drift, hyperreflexia, positive Hoffman sign, and presence of the Babinski sign.[emedicine.medscape.com]
Akinesia
  • […] its rarely encountered, general slowing of the thought process and activity or even akinetic mutism may complicate such a resection. 1 The middle third receives the central group of cortical veins and its sacrifice carries the risk of hemiplegia and akinesia[clinicalgate.com]
  • […] general slowing of the patient’s thought process and activity, or even akinetic mutism, are reported after such sacrifice, although these phenomena are rare. 15 Sacrifice of the middle third causes hemiplegia, more prominent in the lower extremities, and akinesia[neupsykey.com]
Excitement
  • Radiosurgery is an exciting treatment strategy and can be used as a primary treatment in all patients with small parasagittal meningiomas, unless there is a significant mass effect or peritumoral edema.[neupsykey.com]
Sensory Seizure
  • Those tumors arising from the middle third of the sagittal sinus and falx are the most common and present with focal motor or sensory seizures or gradual loss of neurological function. usually beginning in the lower extremity.[meningiomas.org]

Workup

  • His initial workup did not reveal an anatomic etiology, and his seizures were originally treated successfully with phenobarbital and carbamazepine.[ajnr.org]
  • […] benign tumours except in cases of pituitary adenoma. [2] Meningiomas are benign, slow-growing, and highly vascularised tumours; it is extremely rare that their onset is apoplectiform, mimicking cerebrovascular incidents and thus affecting diagnostic workup[cancerjournal.net]
Citrobacter Koseri
  • koseri abscess associated with parasagittal meningioma. ( 17152669 ) Lind C.R....Bok A.P. 2005 33 Parasagittal meningioma en plaque with extracranial extension presenting diffuse massive hyperostosis of the skull. ( 14751632 ) Akutsu H....Matsumura A[malacards.org]
  • Peritumoral Citrobacter koseri abscess associated with parasagittal meningioma. Neurosurgery. 2005 Oct;57(4):E814. PubMed PMID: 17152669. 25: 26: Mathuriya SN, Vasishta RK, Dash RJ, Kak VK.[operativeneurosurgery.com]

Treatment

  • We discuss the epidemiological and clinical features of childhood meningiomas and issues of their diagnosis, treatment, and prognosis.[ncbi.nlm.nih.gov]
  • Radiation treatment is associated with significant morbidity and is reserved as a salvage treatment in recurrent cases unresponsive to other treatment methods. 6.[neupsykey.com]
  • Surgical resection is the first choice of treatment for meningiomas.[spandidos-publications.com]
  • Three patients complained of protracted headaches after treatment. Conclusions: LINAC radiosurgery was highly effective for the treatment of parasagittal meningiomas in this series.[karger.com]
  • 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]

Prognosis

  • We discuss the epidemiological and clinical features of childhood meningiomas and issues of their diagnosis, treatment, and prognosis.[ncbi.nlm.nih.gov]
  • In general, the more differentiated the tissue and the lower the grade, the better the prognosis.[cancermedicines.in]

Etiology

  • 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]
  • Conclusion The etiology of extraaxial, supratentorial ependymomas is unclear.[ajnr.org]
  • The most likely etiology of transient deficits following SSS ligation is venous hypertension and edema, but these are readily detected on postoperative CT perfusion or MRI studies.[hoajonline.com]
  • "Epidemiology and etiology of meningioma". Journal of Neuro-Oncology. 99 (3): 307–14. doi : 10.1007/s11060-010-0386-3. PMC 2945461. PMID 20821343. a b Starr, CJ; Cha, S (26 May 2017).[en.wikipedia.org]
  • References Bondy M, Ligon BL (1996) Epidemiology and etiology of intracranial meningiomas: a review. J Neurooncol 29: 197-205. Longstreth WT Jr, Dennis LK, McGuire VM, Drangsholt MT, Koepsell TD (1993) Epidemiology of intracranial meningioma.[omicsonline.org]

Epidemiology

  • We discuss the epidemiological and clinical features of childhood meningiomas and issues of their diagnosis, treatment, and prognosis.[ncbi.nlm.nih.gov]
  • Joint Conference of the International Society for Environmental Epidemiology (ISEE) and the International Society for Exposure Assessment (ISEA), September 2-6, 2006, Paris, in: Epidemiology, 17, 6, 74.[emf.ethz.ch]
  • "Epidemiology and etiology of meningioma". Journal of Neuro-Oncology. 99 (3): 307–14. doi : 10.1007/s11060-010-0386-3. PMC 2945461. PMID 20821343. a b Starr, CJ; Cha, S (26 May 2017).[en.wikipedia.org]
  • Epidemiology of Meningioma Meningiomas account for 13 to 17 per cent of intracranial tumors in the United States. They are probably more common than realized and comprise 33 per cent of asymptomatic brain tumors in a series of 300 autopsies.[brain-tumors.tripod.com]
  • References Bondy M, Ligon BL (1996) Epidemiology and etiology of intracranial meningiomas: a review. J Neurooncol 29: 197-205. Longstreth WT Jr, Dennis LK, McGuire VM, Drangsholt MT, Koepsell TD (1993) Epidemiology of intracranial meningioma.[omicsonline.org]
Sex distribution
Age distribution

Pathophysiology

  • Meningiomas with hemorrhagic onset remain rare, and pathophysiology is still incompletely understood. Prevention and outcome of intratumoral haemorrhage highly depends on early diagnosis and adequate treatment.[cancerjournal.net]
  • PATHOPHYSIOLOGY raised intracranial pressure, disruption of cortical electrophysiology or direct mass effect on adjacent neural structures. Clinical symptoms from meningiomas develop as a result of 29 August 2016 6 7.[slideshare.net]
  • The detailed mechanism and pathophysiology of perilesional imaging changes after radiosurgery are unclear. Most peritumorous imaging changes are believed to be attributable to vasogenic oedema.[jnnp.bmj.com]
  • Mutations in NF2 are commonly expressed in meningiomas located in the cerebral and cerebellar hemispheres. [13] Pathophysiology [ edit ] Micrograph of a meningioma with brain invasion (WHO Grade II); the tumour (bottom/right of image) has the typical[en.wikipedia.org]

Prevention

  • An appropriate treatment of the involved sagittal sinuses is extremely important for preventing the post-operative recurrence of tumors.[spandidos-publications.com]
  • Certain drugs can help prevent or control them.[cancer.net]
  • Prevention and outcome of intratumoral haemorrhage highly depends on early diagnosis and adequate treatment. Keywords: Meningioma, intracranial, spinal, haemorrhage How to cite this article: Vij M, Jaiswal S, Jaiswal AK, Kumar S, Behari S.[cancerjournal.net]
  • Whether, or how much, the tumor contributes to venous drainage of the region is not known. 16 Management Strategy The goal in managing this type of “problem” meningioma is clear: keep the patient fully functional and prevent or provide long-term relief[neupsykey.com]

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