Therapeutic targets Pain relief Treatment of cerebral edema Treatment of symptoms: Epilepsy (seizures) → antiepileptic drugs. Therapy recommendations For cerebral edema: Dexamethasone (glucocorticoids), first-line agent. For acute treatment of severe cerebral edema: osmodiuretics (drugs with a dehydrating effect). Mannitoline infusions (20%, maximum 6 x 250 ml/day). Analgesia according to WHO staging scheme (see under “Chronic … Meningiomas: Drug Therapy
Obligatory medical device diagnostics. Computed tomography of the skull (cranial CT or cCT) with intravenous contrast agent – due topropensity for calcification or bone infiltration. Magnetic resonance imaging of the skull (cranial MRI or cMRI) with intravenous contrast agent [gold standard]. Advantage: MRI has the greatest soft tissue contrast. Optional medical device diagnostics – depending … Meningiomas: Diagnostic Tests
The medical history (history of the patient) represents an important component in the diagnosis of meningiomas. Family history What is the general health of your family members? Are there any diseases in your family that are common? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical … Meningiomas: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Monosomy 22 – chromosome 22 is present only once. Neurofibromatosis type 2 – genetic disease with autosomal dominant inheritance; belongs to the phakomatoses (diseases of the skin and nervous system); characteristic are an acoustic neuroma (vestibular schwannoma) present bilaterally (on both sides) and multiple meningiomas (meningeal tumors) Blood, … Meningiomas: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by meningiomas: Neoplasms – Tumor diseases (C00-D48). Metastases (daughter tumors) – in anaplastic meningioma. Psyche – nervous system (F00-F99; G00-G99). Affective disorders (mood disorders) Depression Epilepsy (seizures) Cerebral edema (swelling of the brain; perifocal edema). Cognitive impairment (memory impairment) Further Complications … Meningiomas: Complications
According to the WHO classification of central nervous system (CNS) tumors, meningiomas can be classified as follows: WHO grade Grade description Diagnosis I Benign (benign) tumors Slow growing Long symptom-free period Recurrence tendency (recurrence): 7-20 %. By surgical removal cure! Meningiomas (80-85%) Variants: Angiomatous Fibromatous Meningeotheliomatous Microcytic Psammomatous Secretory Transitional II Benign Tumors often growing … Meningiomas: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Eyes [exophthalmos (pathologic protrusion of the eyeball from the orbit)] Gait [gait disturbances] Palpation (palpation) Head (bump due tohyperostosis … Meningiomas: Examination
2nd order laboratory parameters-depending on the results of the history, physical examination, and obligatory laboratory parameters-for differential diagnosis in disorders of consciousness or meningioma. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood). Electrolytes – sodium, … Meningiomas: Test and Diagnosis
Indications for neurosurgical removal: Symptomatic meningiomas Asymptomatic meningiomas with progressive growth If possible, complete resection of the tumor (by stereotaxy if necessary). If it is a vascular meningioma, preoperative embolization (artificial occlusion of blood vessels) should be performed. If the meningioma cannot be completely removed because it is too close to important structures, or if … Meningiomas: Surgical Therapy
To prevent meningioma, attention must be paid to reducing individual risk factors. Behavioral risk factors Overweight (BMI ≥ 25; obesity)-higher likelihood of developing meningioma: BMI 25-29.9: 21% BMI ≥ 30: 54 Medication Cyproterone (synthetic progesterone derivative). Radiotherapy After computed tomography (CT) of the head and neck, the risk of malignant (malignant) brain tumors in children … Meningiomas: Prevention
The clinical picture depends on the location of the meningioma as well as the extent of tumor-induced increase in intracranial pressure (intracranial pressure). The following symptoms and complaints may indicate meningioma: Main symptoms Dysosmia (olfactory disturbances). Epileptic seizures (convulsive seizures) Exophthalmos (pathological protrusion of the eyeball from the orbit). Brain pressure signs – headache, nausea … Meningiomas: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Meningiomas arise from the covering cells of the arachnoid mater (spider web membrane; middle, soft meninges). Why the cells of the arachnoid degenerate has not yet been determined (spontaneous mutations). Meningiomas are located close to the midline, often on the sphenoid wing (falx cerebri). They are usually well demarcated as well … Meningiomas: Causes
