Infiltrative Meningioma Research Articles

Meningioma Infiltrative Accompanied by Organic Delusional Disorders

A B S T R A C TIntroduction. Meningiomas are primary extra-axial tumours of the central nervoussystem (CNS) with an incidence of 2 in 100,000 in adults. There is an estimate of a3: 1 female predominance of these tumours mainly due to the action of estrogen.Meningiomas are commonly associated with headaches, imbalances, visualdisturbances, and other neurological problems which can be very debilitating. Thiscase report will describe a case of a brain tumour accompanied by psychiatricdisorders. Case presentation. Mrs W, a 37 years old woman, a housewife, Javanese,Moslem, married, lower socioeconomic background, came with her family to theNeurology polyclinic because she experienced changes in behaviour since sevenmonths ago in the form of much silence, daydreaming, cannot communicate,sometimes talking to herself, eating drinking and bathing must be helped and served.Four months before being admitted to the hospital, because the patient's headachesworsened and the patient became increasingly withdrawn, accompanied by weaknessin both legs. From the results of CT-scan with contrast, the results showed that themeningioma infiltrates and perifocal oedema, which caused subfalcine herniation asfar as 2.73 cm to the right. Conclusion. Infiltrative meningioma is often accompaniedby mental disorders in the form of personality changes, depressive-like symptomsand neurological symptoms. Clinicians should be able to detect a brain mass so thatmanagement can be undertaken immediately.

Meningioma of the pineal region: a surgical series of 10 cases.

Ten cases of meningioma of the pineal region were histologically verified at a single institution during an 8-year period. These represented 0.3% of 3061 intracranial meningiomas, as well as 6.2% of 164 pineal tumors. Patients were predominantly women. Symptoms and signs of increased intracranial pressure were most common, whereas Parinaud's syndrome was observed in only one case. Computerized tomography (CT) was the main diagnostic test used in the present series. It usually revealed a hyperdense mass with high-intensity contrast enhancement and a calcified mass eccentrically located at the periphery, which returned to its central location postsurgically and was likely to represent a calcified pineal gland. Magnetic resonance imaging was performed in the more recent cases and confirmed the suspicion raised by CT of a meningioma with a calcified mass at its periphery. Surgery was performed using an occipital transtentorial microsurgical approach with the patient placed in the semisitting position. Gross-total tumor removal was achieved in all cases, although this required sacrifice of the vein of Galen in six patients. Venous occlusion was performed only after adequate intraoperative verification of functional occlusion and blood flow diversion from the galenic system and had no consequences in any case but one. This latter patient had an infiltrative meningioma that was removed at the expense of intraoperative sacrifice of the two internal cerebral veins, as well as unavoidable trauma to the region of the quadrigeminal plate. All the remaining patients improved postsurgery, and only one had a permanent visual field deficit as a result of the surgical approach. Pineal meningiomas represent a rare subgroup of pineal tumors that can be treated surgically with reasonably good results. Sacrifice of major basal veins may be required to achieve radical tumor removal and can be tolerated by the patient provided that functional occlusion of the galenic system, as indicated by preoperative angiography, is verified during surgery.