Intracranial meningioma

Meningiomas are the most common benign intracranial tumor, accounting for 15-30% of all primary intracranial tumors. They are usually diagnosed between 40-60 years and they are more common in females, but the aggressive type is more common in men and children. Pathologically, Meningiomas are divided into three grades: 1-Benign [90%] 2-Atypical [5-7%] 3-Anaplastic [3-5%]. The gross appearance of Meningioma is usually globular mass with regular surfaces and attached to the dura, but there is a certain type called meningioma en plaque, has a flattened appearance that conforms to the curves of the brain and the inside of the skull. Studying the immunohistochemistry and the biological activity of this tumor showed the presence of Epithelial Membrane Antigen [EMA] in 80% of cases, in addition to the presence of progesterone receptors in 57- 67% of cases which is associated with a good histological grade, lower frequency of recurrence, and overall favourable prognosis. Many causes are thought to be associated with meningioma like trauma, viral infection, radiation and genetic factors. The signs and symptoms are variable, and some of them are specific to the location of the tumor. The diagnosis of meningioma is done by CT scan and MRI, in addition to nuclear imaging and MRSpectroscopy. In many cases, angiography is also done either conventional or via MRAngiography. The treatment methods depend on the size and site of tumor, patient's age and clinical presentation starting by clinical observation and ending by surgical management. This article will discuss all of the above in detail with review of the medical literature