1/179. meningioma of the cavernous sinus in a child.Intracranial meningiomas in children are rare, representing 1-4.2% of central nervous system tumors and 1.5-1.8% of all intracranial meningiomas. Meningiomas arising from the lateral wall of the cavernous sinus account for less than 1% of all intracranial meningiomas. To our knowledge, only one case of a meningioma arising from the cavernous sinus has been reported in childhood. A 6-year-old boy presented with left ophthalmoplegia. A slight drooping of the left eyelid was noted at the age of 1 year. magnetic resonance imaging (MRI) with contrast administration revealed an enhancing mass lesion located in the left cavernous sinus. The tumor, arising from the lateral wall of the cavernous sinus, was totally removed and the oculomotor nerve was reconstructed with a sural nerve graft. MRI displayed total tumor removal 1 month after the surgery. The pathological diagnosis was of a psammomatous meningioma.- - - - - - - - - - ranking = 1keywords = sinus (Clic here for more details about this article) |
2/179. Non-surgical treatment of meningioma: a case report and review.A woman initially presented with a right hemiparesis and subsequently underwent subtotal resection of a left parietal meningioma arising from the lateral wall of the sagittal sinus. She again presented 18 months after surgery with a hemiparesis and repeat MRI showed tumour spreading into the sagittal and the transverse sinuses. She had a therapeutic abortion at 8 weeks gestation 3 weeks prior to her representation. gestrinone, a synthetic steroid and an antiprogesterone was commenced. Two months later she stopped her medication and is asymptomatic at 16 months. A follow-up MRI revealed that the tumour had shrunk dramatically. This case is the first of its kind with tumour size reduction to less than 20%. We feel that the future of meningioma treatment will be multi-disciplinary and non-surgical options should be considered.- - - - - - - - - - ranking = 0.25keywords = sinus (Clic here for more details about this article) |
3/179. Diffuse calvarial meningioma. Case report and review of the literature.An extremely unusual calvarial meningioma in a 77-year-old woman is reported. The meningioma spread widely and symmetrically within the calvaria and grew extracranially within the scalp as well as intracranially. Reactive dural hyperplasia induced narrowing of the intracranial space and occlusion of the superior sagittal sinus, resulting in intracranial hypertension. After external decompression, the patient's symptoms markedly resolved. The authors review the literature on calvarial meningioma, discuss its pathogenesis, and propose mechanisms responsible for the patient's intracranial hypertension.- - - - - - - - - - ranking = 0.125keywords = sinus (Clic here for more details about this article) |
4/179. Meningotheliomatous meningioma accompanied by aspergillosis at the skull base.A 73-year-old man was admitted because of right frontal headache and gradual loss of right visual acuity, which had been occurring for 1 year. He had been treated with corticosteroids under the diagnosis of retrobulbar optic neuritis at a nearby clinic. magnetic resonance imaging (MRI) revealed a nodular lesion at the tuberculum sellae, which showed isointensity on T1-weighted images, iso- to low-intensity on T2-weighted images, and heterogeneous enhancement with Gd-DTPA. meningioma was diagnosed, and surgery was performed but was limited to biopsy because of intraoperative detection of purulent inflammation of the nodule. Histologic examination revealed aspergillosis in a portion of the meningotheliomatous meningioma. The patient died of meningoencephalitis about 1 month after surgery in spite of extensive treatment with antifungal agents. MRI findings of meningioma and aspergillosis are similar, thus making preoperative diagnosis difficult. However, this case provides evidence that aspergillosis should be included in the differential diagnosis when a skull-base meningioma-like nodule is noted if sinusitis is revealed in the sphenoid sinus.- - - - - - - - - - ranking = 0.25keywords = sinus (Clic here for more details about this article) |
5/179. A new subtype of meningioma.Three patients with small meningiomas presented with diffuse cerebral edema that was out of proportion to the size of tumors. All lesions were small and no brain invasion or unusual tumor vascularity or dural sinus involvement was noted in any of the three cases. Tumor material was subjected to conventional and immunohistochemical stains. All three tumors showed benign meningothelial components, prominent formation of hyaline inclusions (pseudopsammoma bodies), and striking vascular mural proliferation of small dark cells. All patients have remained asymptomatic without any evidence of tumor recurrence after a follow-up of 4-6 years. These tumors showed proliferation of pericytes in blood vessel walls and, therefore, represent a new subtype of meningothelial meningioma. In the study presented here, the location, size, histotype, and clinical findings that may influence the development of peritumoral brain edema are discussed in detail.- - - - - - - - - - ranking = 0.125keywords = sinus (Clic here for more details about this article) |
6/179. meningioma presenting as tolosa-hunt syndrome.A 23-year-old woman was admitted with headache, nausea, vomiting and blurred vision on the left side. Neurological examination showed ptosis with a complete internal and external ophthalmoplegia and a red fullness around the left orbita. Computed tomographic scanning of the brain revealed no abnormalities. As she improved on high doses of steroids a diagnosis of tolosa-hunt syndrome (THS) seemed to be indicated. However, magnetic resonance imaging (MRI) showed a lesion with intermediate signal intensity in the left cavernous sinus. craniotomy was performed when symptoms of THS recurred. Histopathological examination revealed a meningioma with a papillary aspect and some mitoses. This case illustrates that: (1) THS is still a diagnosis by exclusion; (2) MRI and histopathological examination are important if there is any doubt about the diagnosis; and (3) also when there is no doubt, improvement after steroid therapy may be a diagnostic pitfall. Therefore, not only MRI but also orbital phlebography and angiography should seriously be considered.- - - - - - - - - - ranking = 0.125keywords = sinus (Clic here for more details about this article) |
7/179. Dural sinus thrombosis and pseudotumor cerebri: unexpected complications of suboccipital craniotomy and translabyrinthine craniectomy.OBJECT: The goal of this study was to document the hazards associated with pseudotumor cerebri resulting from transverse sinus thrombosis after tumor resection. Dural sinus thrombosis is a rare and potentially serious complication of suboccipital craniotomy and translabyrinthine craniectomy. pseudotumor cerebri may occur when venous hypertension develops secondary to outflow obstruction. Previous research indicates that occlusion of a single transverse sinus is well tolerated when the contralateral sinus remains patent. methods: The authors report the results in five of a total of 107 patients who underwent suboccipital craniotomy or translabyrinthine craniectomy for resection of a tumor. Postoperatively, these patients developed headache, visual obscuration, and florid papilledema as a result of increased intracranial pressure (ICP). In each patient, the transverse sinus on the treated side was thrombosed; patency of the contralateral sinus was confirmed on magnetic resonance (MR) imaging. Four patients required lumboperitoneal or ventriculoperitoneal shunts and one required medical treatment for increased ICP. All five patients regained their baseline neurological function after treatment. Techniques used to avoid thrombosis during surgery are discussed. CONCLUSIONS: First, the status of the transverse and sigmoid sinuses should be documented using MR venography before patients undergo posterior fossa surgery. Second, thrombosis of a transverse or sigmoid sinus may not be tolerated even if the sinus is nondominant; vision-threatening pseudotumor cerebri may result. Third, MR venography is a reliable, noninvasive means of evaluating the venous sinuses. Fourth, if the diagnosis is made shortly after thrombosis, then direct endovascular thrombolysis with urokinase may be a therapeutic option. If the presentation is delayed, then ophthalmological complications of pseudotumor cerebri can be avoided by administration of a combination of acetazolamide, dexamethasone, lumbar puncture, and possibly lumboperitoneal shunt placement.- - - - - - - - - - ranking = 1.75keywords = sinus (Clic here for more details about this article) |
8/179. Tentorial meningioma encroaching the transverse sinuses and sigmoid sinus junction area associated with dural arteriovenous fistulous malformation: a case report.A 62-year-old woman was evaluated for tinnitis and headache. magnetic resonance imaging and angiography revealed the coexistence of a tentorial tumor encroaching the junction of the right transverse-sigmoid sinuses, and dural arteriovenous fistulous malformation (AVFM) of the right transverse sinus. AVFM was not manipulated at all during the surgery. The pathology was fibroblastic meningioma. Postoperatively, the dural AVFM completely disappeared on follow-up angiography. The fistulas were occluded also after surgery, even though there was no manipulation of the AVFM. It is suggested that the right dominant transverse-sigmoid sinuses are partially occluded by tentorial meningioma, developing the dural arteriovenous fistula of the right transverse sinus. An acquired origin of the dural AVFM was suggested in this case.- - - - - - - - - - ranking = 1.5keywords = sinus (Clic here for more details about this article) |
9/179. meningioma metastatic to the lung.Meningiomas constitute 15% to 18% of all primary intracranial and intraspinal tumors. Distant extracranial metastases are reported to occur in fewer than 1 in 1000 cases. Of 1992 primary intracranial meningiomas seen at Mayo Clinic Rochester from 1972 through 1994, we identified 3 (0.15%) with documented extracranial metastasis. A review of the literature suggests that previous craniotomy, venous sinus invasion, local recurrences, histological malignancy, and papillary morphology may be risk factors for systemic spread, as demonstrated in our cases. Although rare, metastatic meningioma should be considered in the differential diagnosis of abnormal findings on chest radiography in patients with known or suspected intracranial meningioma.- - - - - - - - - - ranking = 0.125keywords = sinus (Clic here for more details about this article) |
10/179. A case of primary meningioma of the frontal sinus.A case of right frontal sinus tumor which at histology turned out to be a psammomatous meningioma is reported. The occurrence of primary meningiomas within the paranasal sinuses is rare and probably related to the transformation of embryonic arachnoid cell remnants or ectopic meningocytes derived from pluripotential mesenchymal cells. A search of the literature disclosed 30 further cases of meningiomas primarily involving the paranasal sinuses: a short analysis of the latters is presented and some of the distinctive features of these unusual tumors, as compared to their intracranial counterpart, are emphasized.- - - - - - - - - - ranking = 3.4310513333729keywords = paranasal sinus, paranasal, sinus (Clic here for more details about this article) |
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