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==Overview==
==Overview==
The hallmark symptom of meningioma is morning [[headache]]. Other common symptoms of meningioma include [[weakness]], facial drooping, and [[confusion]]. However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the [[tumor]].<ref name="wiki"> Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#Signs_and_symptoms Accessed on September, 25 2015</ref><ref name="UCLA">Meningioma Brain Tumor. UCLA Neurosurgery(2015) http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=62&action=detail Accessed on September, 25 2015</ref><ref name="radio"> Meningioma. Radiopaedia (2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
Patients with meningioma may have a history of past [[radiation]] exposure, [[Genetic disorder|genetic disorders]] like [[neurofibromatosis type II]], and [[obesity]]. The hallmark symptom of meningioma is morning [[headache]]. Other common symptoms of meningioma include [[vomiting]], focal neurological deficits, [[hearing loss]]/[[tinnitus]], visual impairment, and behavioral changes. However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the [[tumor]]. For example, patients with meningiomas located in the olfactory grove may present with memory and visual disturbances, loss of intellectual functions, and unilateral or bilateral inability to smell.


==History==
==History and Symptoms==
* When evaluating a patient for meningioma, you should take a detailed history of the presenting symptom (duration, onset, progression), other associated symptoms, and a thorough past medical history review. Other specific areas of focus when obtaining the history are:<ref name="Canada">Risk factors for brain and spinal cord cancer. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/risks/?region=mb Accessed on September, 25 2015</ref><ref name="pmid20821343">{{cite journal| author=Wiemels J, Wrensch M, Claus EB| title=Epidemiology and etiology of meningioma. | journal=J Neurooncol | year= 2010 | volume= 99 | issue= 3 | pages= 307-14 | pmid=20821343 | doi=10.1007/s11060-010-0386-3 | pmc=PMC2945461 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20821343  }} </ref>
** Review of any excessive cell phone use 
** Review of any exposure to head [[radiation therapy]] or dental [[X-ray]]
** Review of any significant [[head trauma]] history in the past


==Symptoms==
=== History ===
===Common Symptoms===
Patients with meningioma may have a positive history of:<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref><ref name="pmid30898941">{{cite journal| author=Antunes C, Ramos R, Machado MJ, Filipe MA| title=Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment. | journal=BMJ Case Rep | year= 2019 | volume= 12 | issue= 3 | pages=  | pmid=30898941 | doi=10.1136/bcr-2018-228454 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30898941  }} </ref><ref name="pmid30846670">{{cite journal| author=Sim SK, Khairul Aizad A, Lim SS, Wong A| title=Large falcine meningioma presented as treatment-resistant depression: A case report. | journal=Med J Malaysia | year= 2019 | volume= 74 | issue= 1 | pages= 87-89 | pmid=30846670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30846670  }} </ref><ref name="pmid30999261">{{cite journal| author=Gyawali S, Sharma P, Mahapatra A| title=Meningioma and psychiatric symptoms: An individual patient data analysis. | journal=Asian J Psychiatr | year= 2019 | volume= 42 | issue=  | pages= 94-103 | pmid=30999261 | doi=10.1016/j.ajp.2019.03.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30999261  }} </ref>
Common symptoms of [disease] include:<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref><ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref><ref name="pmid30898941">{{cite journal| author=Antunes C, Ramos R, Machado MJ, Filipe MA| title=Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment. | journal=BMJ Case Rep | year= 2019 | volume= 12 | issue= 3 | pages=  | pmid=30898941 | doi=10.1136/bcr-2018-228454 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30898941  }} </ref><ref name="pmid30846670">{{cite journal| author=Sim SK, Khairul Aizad A, Lim SS, Wong A| title=Large falcine meningioma presented as treatment-resistant depression: A case report. | journal=Med J Malaysia | year= 2019 | volume= 74 | issue= 1 | pages= 87-89 | pmid=30846670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30846670  }} </ref>
 
*Headache
*Past [[radiation]] exposure
*[[Neurofibromatosis type II]]
*[[Obesity]]
*[[Headache|Headaches]]
*[[Seizure|Seizures]]
*[[Nausea]]/[[vomiting]]
*Neurological deficits
*Personality changes
*[[Hearing loss]]/[[tinnitus]]
 
===Symptoms===
Common symptoms of meningioma include:<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref><ref name="pmid30898941">{{cite journal| author=Antunes C, Ramos R, Machado MJ, Filipe MA| title=Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment. | journal=BMJ Case Rep | year= 2019 | volume= 12 | issue= 3 | pages=  | pmid=30898941 | doi=10.1136/bcr-2018-228454 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30898941  }} </ref><ref name="pmid30846670">{{cite journal| author=Sim SK, Khairul Aizad A, Lim SS, Wong A| title=Large falcine meningioma presented as treatment-resistant depression: A case report. | journal=Med J Malaysia | year= 2019 | volume= 74 | issue= 1 | pages= 87-89 | pmid=30846670 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30846670 }} </ref><ref name="pmid30999261">{{cite journal| author=Gyawali S, Sharma P, Mahapatra A| title=Meningioma and psychiatric symptoms: An individual patient data analysis. | journal=Asian J Psychiatr | year= 2019 | volume= 42 | issue=  | pages= 94-103 | pmid=30999261 | doi=10.1016/j.ajp.2019.03.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30999261 }} </ref>
*[[Headache]]
*Visual impairment  
*Visual impairment  
*Seizures
*[[Seizure|Seizures]]
*Vomiting
*[[Vomiting]]
*Loss in the sense of smell
*Loss of the sense of smell
*Numbness
*[[Numbness]]
*Behavioral changes
*Behavioral changes
*Psychiatric symptoms
*Psychiatric symptoms
*Muscle weakness  
*[[Muscle weakness]]
* Some patients with meningioma are asymptomatic. In cases like these, the tumor is usually found incidentally.<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref>
*[[Urinary incontinence]]
* Some patients with meningioma are [[asymptomatic]]. In cases like these, the [[tumor]] is usually found incidentally.<ref name="pmid29492130">{{cite journal| author=Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF et al.| title=Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy. | journal=Asian J Neurosurg | year= 2018 | volume= 13 | issue= 1 | pages= 86-89 | pmid=29492130 | doi=10.4103/1793-5482.181115 | pmc=5820904 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29492130  }} </ref>


* General symptoms of meningioma include:<ref name="wiki"> Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#Signs_and_symptoms Accessed on September, 25 2015</ref><ref name="UCLA">Meningioma Brain Tumor. UCLA Neurosurgery(2015) http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=62&action=detail Accessed on September, 25 2015</ref><ref name="radio"> Meningioma. Radiopaedia (2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
* However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the [[tumor]]:
:* Morning [[headache]]
:* [[Weakness]] and focal neurological deficit
:* [[Confusion]]


* However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the tumor:<ref name="wiki"> Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma#Signs_and_symptoms Accessed on September, 25 2015</ref><ref name="UCLA">Meningioma Brain Tumor. UCLA Neurosurgery(2015) http://neurosurgery.ucla.edu/body.cfm?id=1123&ref=62&action=detail Accessed on September, 25 2015</ref><ref name="radio"> Meningioma. Radiopaedia (2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
:*'''Symptoms observed in [[olfactory]] groove meningioma include:'''<ref name="Welge-Luessen2001">{{cite journal|last1=Welge-Luessen|first1=A|title=Olfactory function in patients with olfactory groove meningioma|journal=Journal of Neurology, Neurosurgery & Psychiatry|volume=70|issue=2|year=2001|pages=218–221|issn=00223050|doi=10.1136/jnnp.70.2.218}}</ref>
:* '''Symptoms observed in [[olfactory]] groove meningioma include:'''
::* [[Urinary incontinence]]
::* Mild personality changes
::* Mild memory loss
::* Decreased [[visual acuity]]
::* Decreased concentration span
::* Inability to smell 


:* '''Symptoms observed in [[cerebral]] convexity meningioma include:'''
::* [[Headache]]
::* Decreased [[visual acuity]]
::* Memory disturbance
::* Speech difficulties
::* Visual disturbances
::* Loss of intellectual functions
::* Inability to smell (unilateral or bilateral) 


:* '''Symptoms observed in posterior fossa meningioma include:'''
:*'''Symptoms observed in posterior fossa meningioma include:'''<ref name="pmid23293666">{{cite journal| author=Velho V, Agarwal V, Mally R, Palande DA| title=Posterior fossa meningioma "our experience" in 64 cases. | journal=Asian J Neurosurg | year= 2012 | volume= 7 | issue= 3 | pages= 116-24 | pmid=23293666 | doi=10.4103/1793-5482.103710 | pmc=3532757 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23293666  }} </ref>
::* [[Headache|Headaches]]
::* [[Cerebral]] dysfunctions
::* [[Hearing loss]]/[[Tinnitus]]
::* Trigeminal anesthesia/Neuralgia
::* [[Facial palsy]]
::* [[Diplopia]]
::* [[Ataxia]]
::* Cerebellar compression syndrome
::* [[Brain stem]] compression syndrome
::* Cranial nerves dysfunction
::* Swallowing diffuclties  
::* Swallowing diffuclties  
::* Voice abnormalities  
::* Voice abnormalities  
::* [[Imbalance]]
::* Loss of coordination
:* '''Symptoms observed in parafalcine meningioma include:'''
::* Significant personality changes
::* [[Tremor]]
::* Imbalance
::* Significant [[memory loss]]
:* '''Symptoms observed in [[cerebellopontine angle]] meningioma include:'''
::* [[Facial palsy|Facial drooping]]
::* [[Dizziness]]
::* Loss of coordination
::* Imbalance
::* Voice abnormalities
::* [[Hearing loss]]
::* Difficulty swallowing


:* '''Symptoms observed in parasagittal frontoparietal meningioma include:'''
:*'''Symptoms observed in parafalcine meningioma include:'''<ref name="pmid30214233">{{cite journal| author=Kong X, Gong S, Lee IT, Yang Y| title=Microsurgical treatment of parafalcine meningiomas: a retrospective study of 126 cases. | journal=Onco Targets Ther | year= 2018 | volume= 11 | issue=  | pages= 5279-5285 | pmid=30214233 | doi=10.2147/OTT.S162274 | pmc=6124789 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30214233  }} </ref>
::* Urinary incontinence
::* Neurologic deficits
::* Spastic [[hemiparesis]]  
::* Visual dysfunction
::* [[Ataxia]]  


:* '''Symptoms observed in [[sphenoid]] ridge meningioma include''':
:*'''Symptoms observed in [[sphenoid]] ridge meningioma include''':<ref name="pmid18975564">{{cite journal| author=Oi S, Saito K, Ichikawa M, Aimi Y, Okada T, Nagatani T et al.| title=[Case of large sphenoid ridge meningioma treated by 2-stage surgery]. | journal=No Shinkei Geka | year= 2008 | volume= 36 | issue= 10 | pages= 885-90 | pmid=18975564 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18975564  }} </ref><ref name="pmid11678395">{{cite journal| author=Honeybul S, Neil-Dwyer G, Lang DA, Evans BT, Ellison DW| title=Sphenoid wing meningioma en plaque: a clinical review. | journal=Acta Neurochir (Wien) | year= 2001 | volume= 143 | issue= 8 | pages= 749-57; discussion 758 | pmid=11678395 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11678395  }} </ref><ref name="pmid28638189">{{cite journal| author=Saha R, Jakhar K, Kumar R| title=Sphenoid Wing Meningioma Presenting as Cognitive Impairment. | journal=Shanghai Arch Psychiatry | year= 2016 | volume= 28 | issue= 3 | pages= 173-176 | pmid=28638189 | doi=10.11919/j.issn.1002-0829.215142 | pmc=5434305 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28638189  }} </ref>
::* Memory loss
::* Decreased [[visual acuity]]  
::* Decreased [[visual acuity]]  
::* [[Exophthalmos]]
::* Focal neurological deficit
::* [[Strabismus]]  
::* [[Proptosis]]  
::* Personality changes
::* [[Cognitive impairment]]


==References==
==References==

Latest revision as of 20:15, 20 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2] Haytham Allaham, M.D. [3]

Overview

Patients with meningioma may have a history of past radiation exposure, genetic disorders like neurofibromatosis type II, and obesity. The hallmark symptom of meningioma is morning headache. Other common symptoms of meningioma include vomiting, focal neurological deficits, hearing loss/tinnitus, visual impairment, and behavioral changes. However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the tumor. For example, patients with meningiomas located in the olfactory grove may present with memory and visual disturbances, loss of intellectual functions, and unilateral or bilateral inability to smell.

History and Symptoms

History

Patients with meningioma may have a positive history of:[1][2][3][4]

Symptoms

Common symptoms of meningioma include:[1][2][3][4]

  • However, the specific clinical presentation of meningioma is determined by the exact anatomical location of the tumor:
  • Symptoms observed in olfactory groove meningioma include:[5]
  • Headache
  • Memory disturbance
  • Visual disturbances
  • Loss of intellectual functions
  • Inability to smell (unilateral or bilateral)
  • Symptoms observed in posterior fossa meningioma include:[6]
  • Symptoms observed in parafalcine meningioma include:[7]
  • Neurologic deficits
  • Visual dysfunction
  • Ataxia

References

  1. 1.0 1.1 1.2 Gurcay AG, Bozkurt I, Senturk S, Kazanci A, Gurcan O, Turkoglu OF; et al. (2018). "Diagnosis, Treatment, and Management Strategy of Meningioma during Pregnancy". Asian J Neurosurg. 13 (1): 86–89. doi:10.4103/1793-5482.181115. PMC 5820904. PMID 29492130.
  2. 2.0 2.1 Antunes C, Ramos R, Machado MJ, Filipe MA (2019). "Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment". BMJ Case Rep. 12 (3). doi:10.1136/bcr-2018-228454. PMID 30898941.
  3. 3.0 3.1 Sim SK, Khairul Aizad A, Lim SS, Wong A (2019). "Large falcine meningioma presented as treatment-resistant depression: A case report". Med J Malaysia. 74 (1): 87–89. PMID 30846670.
  4. 4.0 4.1 Gyawali S, Sharma P, Mahapatra A (2019). "Meningioma and psychiatric symptoms: An individual patient data analysis". Asian J Psychiatr. 42: 94–103. doi:10.1016/j.ajp.2019.03.029. PMID 30999261.
  5. Welge-Luessen, A (2001). "Olfactory function in patients with olfactory groove meningioma". Journal of Neurology, Neurosurgery & Psychiatry. 70 (2): 218–221. doi:10.1136/jnnp.70.2.218. ISSN 0022-3050.
  6. Velho V, Agarwal V, Mally R, Palande DA (2012). "Posterior fossa meningioma "our experience" in 64 cases". Asian J Neurosurg. 7 (3): 116–24. doi:10.4103/1793-5482.103710. PMC 3532757. PMID 23293666.
  7. Kong X, Gong S, Lee IT, Yang Y (2018). "Microsurgical treatment of parafalcine meningiomas: a retrospective study of 126 cases". Onco Targets Ther. 11: 5279–5285. doi:10.2147/OTT.S162274. PMC 6124789. PMID 30214233.
  8. Oi S, Saito K, Ichikawa M, Aimi Y, Okada T, Nagatani T; et al. (2008). "[Case of large sphenoid ridge meningioma treated by 2-stage surgery]". No Shinkei Geka. 36 (10): 885–90. PMID 18975564.
  9. Honeybul S, Neil-Dwyer G, Lang DA, Evans BT, Ellison DW (2001). "Sphenoid wing meningioma en plaque: a clinical review". Acta Neurochir (Wien). 143 (8): 749–57, discussion 758. PMID 11678395.
  10. Saha R, Jakhar K, Kumar R (2016). "Sphenoid Wing Meningioma Presenting as Cognitive Impairment". Shanghai Arch Psychiatry. 28 (3): 173–176. doi:10.11919/j.issn.1002-0829.215142. PMC 5434305. PMID 28638189.


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