Presentation
Progressive headache, blurring of vision, dizziness.
Patient Data
A fairly well-defined intensely enhancing extra-axial lesion suggestive of meningioma is noted involving the left sphenoid wing, extending superiorly into the left middle and anterior cranial fossa with mass effect, displacing the adjacent frontotemporal lobes, causing extensive white matter edema. There is a dural tail sign.
There is compression of the left lateral ventricle due to mass effect, midline shift of 1.6 cm towards the right side with subfalcine and descending transtentorial cerebral herniation.
No invasion of the parenchyma. No vascular complications like thrombosis, although the left middle cerebral artery at the Sylvian fissure is compressed and displaced due to mass-effect.
No hyperostosis, bony erosion, or calcification.
Case Discussion
Surgery is the treatment of choice for this meningioma as there is significant mass effect and midline shift. If there is incomplete resection of the lesion, then external-beam radiation therapy can be used.
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