Forehead lump

Introduction The frontal mass may be caused by different diseases, and meningioma is one of the factors: Meningiomas are very common, accounting for 15.31% of intracranial tumors, second only to glioma. There are more adults, fewer elderly and children, and fewer infants and young children. Women are slightly more than men. Meningioma originates from arachnoid endothelial cells, and all the arachnoid granules and arachnoid villi are common sites of meningioma. Beside the sagittal sinus, the convex surface of the brain, the cerebral palsy is more common, followed by the sphenoid ridge, saddle nodule, bronchial groove, cerebellopontine angle and cerebellum, etc., growing in the cerebral ventricle is rare, also seen in hard Out of the membrane. There are still ectopic meningioma, occasionally seen in the skull barrier, frontal sinus, nasal scalp or neck, from the ectopic arachnoid tissue, not metastasis, meningioma has multiple, accounting for about 1% to 2%, Can be as many as dozens, scattered in the same part, one of the large tumor nodules, as well as small tumors, as large as walnuts, as small as miliary, on-screen meningioma is far more than the curtain. In addition, meningiomas can exist in the brain simultaneously with gliomas and neurofibromas, and can also coexist with hemangioma.

Cause

The occurrence of meningioma may be related to certain internal environmental changes and genetic variation, not caused by a single factor, and may be related to factors such as craniocerebral trauma, radiation exposure, viral infection, and bilateral auditory neuroma.

Meningioma grows spherically and has clear boundaries with brain tissue. The tumor has a dense gray or dark red tissue, sometimes containing grit. Intratumoral necrosis can be seen in malignant meningiomas. Meningiomas can sometimes thicken or thin their adjacent skulls. The tumor size can range from 1 cm cm in diameter to more than 10 cm. The tumor is mostly spherical, conical, flat or dumbbell shaped.

an examination

Related inspection

Cranial transillumination test cerebral angiography CT plain scan

The clinical features of meningioma are slow onset and long duration. Meningioma in different parts may have different clinical manifestations. Because adults have more morbidity, adults have chronic headache, mental changes, epilepsy, loss of vision on one or both sides, or blindness, ataxia or limited skull. Blocks, etc., especially when accompanied by progressive exacerbations of increased intracranial pressure, consider the possibility of meningiomas. Fundus examination often finds chronic optic nerve head edema or has been secondary atrophy.

The diagnosis of a tumor also depends on an auxiliary diagnostic test. Diagnosing meningiomas, which have important reference values, include flat slices of the skull, CT scans, and cerebral angiography. Not only can you achieve positioning, but you can also understand tumor size and characterization.

1. Skull plain film: intracranial meningioma requires routine imaging of skull bone, about 75% of cases can show signs of intracranial tumors on plain films, and 30% to 60% of cases can make meninges according to the signs of plain films. Diagnosis of the tumor. X-ray skull flat film signs, part of the intracranial tumor, indirect signs of increased intracranial pressure, such as the erosion and enlargement of the saddle bone, cerebral gyrus and the calcification of the pineal calcification, in a few cases, the skull Separation. The other part is the direct cause of meningioma, including local bone hyperplasia and destruction of the tumor, the widening and increase of meningeal sulcus caused by increased tumor blood supply, tumor calcification, local bone thinning, etc. These are often meningioma A reliable basis for diagnosis.

2. CT scan: In the diagnosis of meningioma, CT scan has replaced isotope brain scan, gas brain and ventriculography, meningioma is mostly substantial and rich in blood supply, most suitable for CT examination, its accuracy can reach the discovery 1cm size meningioma. On the CT scan image, meningioma has its special signs, showing a limited contrast-enhanced contrast-enhanced image in the skull, and there is bone hyperplasia, and there is a density of brain edema around the tumor. Brain shift, and signs of hydrocephalus caused by cerebrospinal fluid circulation obstruction.

3. Cerebral angiography: For some meningioma, cerebral angiography is still necessary. Especially for deep meningioma, its blood supply is multi-channel. Only through cerebral angiography can we understand the source of tumor supply, the degree of tumor blood supply and the distribution of adjacent blood vessels. These are the surgical plans and research operations. Both the approach and the surgical approach have important value. If the selective external carotid artery, internal carotid artery and vertebral artery angiography, especially digital subtraction angiography, the signs of vascular changes are clearer and clearer.

4. In addition, lumbar puncture can reflect the increase of intracranial pressure and increased protein content of cerebrospinal fluid, and it still has certain reference significance in diagnosis and differential diagnosis.

Differential diagnosis

Need to do detailed identification, trauma, other brain tumors can also cause frontal masses. Can do CT to make a difference.

The clinical features of meningioma are slow onset and long duration. Meningioma in different parts may have different clinical manifestations. Because adults have more morbidity, adults have chronic headache, mental changes, epilepsy, loss of vision on one or both sides, or blindness, ataxia or limited skull. Blocks, etc., especially when accompanied by progressive exacerbations of increased intracranial pressure, consider the possibility of meningiomas. Fundus examination often finds chronic optic nerve head edema or has been secondary atrophy.

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