Diagnosis:
Suggested by MRI and confirmed by pathology (brain biopsy/resection)
Findings on Investigations:
CT: hyperdense, uncommonly calcify,
MRI:
- Extraaxial, parasagittal dura >convexities >sphenoid wing >cerebellopontine angle cistern >olfactory groove >plantum sphenoidale. May encase arteries. May invade bone (hyperostotic or osteolytic).
- T1: hypointense, enhancement of lesion & dural tail. Vascular flow voids may occur.
- T2: hypointense, with hyperintense CSF surrounding it ‘cleft sign’,
Catheter angiography: tumor blush and blood supply is noted.
Pathology:
Well circumscribed, attached to dura
Histology: monomorphic cells, round/oval nuclei, syncytium. psammoma bodies, whorls, capsule. Brain invasion defines WHO grade II meningioma
Immunohistochemistry: positive for vimentin, EMA. Negative for GFAP
Associated with neurofibromatosus type 2
Treatment:
Surgical excision
Consider preoperative Catheter angiography