Workup/Staging

Question 1

What is the most common Sx at presentation for meningiomas?

Answer 1

HA is the most common presenting Sx.

Question 2

What is the appearance of meningiomas on CT/MRI?

Answer 2

Homogeneously and intensely enhancing mass, +/– dural tail

Question 3

What % of meningiomas exhibit a dural tail? In what other tumors/lesions can dural tails be seen?

Answer 3

60%. Dural tails can also be seen in chloroma, lymphoma, and sarcoidosis.

Question 4

What proportion of incidentally found meningiomas remain stable on imaging?

Answer 4

Two-thirds. The majority remain stable on imaging.

Question 5

For meningiomas, with what are slower growth rates associated?

Answer 5

Slower growth rates are associated with older pts and calcifications.

Question 6

What surgical grading system is used in meningiomas? For what does it predict?

Answer 6

Simpson grade (I/GTR–V/decompression) predicts the likelihood of LR.

Question 7

In what anatomic regions is GTR more difficult to achieve for meningioma resection?

Answer 7

Cavernous sinus, petroclival region, postsagittal sinus, and optic nerve

Question 8

How is optic sheath meningioma diagnosed?

Answer 8

Optic sheath meningioma is diagnosed clinically/radiographically by a neuro-ophthalmologist/MRI (no Bx).