Case Report: Radiological diagnosis of atypical meningioma

Meningiomas are one of the most commonly occurring, extra-axial, primary tumors of central nervous system that are slow-growing in nature with a female predominance mostly occurring in the mid-late twenties. The clinical symptoms of atypical meningioma include headache, seizures, change in personality or behavior, development of a localized neurologic impairment, drowsiness, confusion, loss of hearing or tinnitus, fatigue on exertion, projectile vomiting and visual disturbances. If a meningioma is left untreated, it can cause problems such as loss of neurological function, weakness/numbness, hearing or vision loss, and balance problems. Sometimes there are worsening signs of persistent headaches, origin of new episodes of seizures, or increased intracranial pressure and neurological evaluation should be performed, followed by radiological studies if necessary. The best investigations for early diagnosis are CT and Magnetic Resonance Imaging scans (MRI). Total surgical excision of the tumor is the best management option for the neurological symptoms. In certain situations, such as atypical, malignant, or recurrent meningioma, radiation with a cumulative dose of 45-60 Gy is now employed There is a long-term re-occurrence rate of completely and incompletely resected atypical meningioma. Radiotherapy is beneficial in patients with low surgical risk, meningiomas in surgically inaccessible areas, and advanced age. Hormonal therapy and chemotherapy can be attempted when meningiomas are unresectable. In recurrent meningiomas, chemotherapy with hydroxyurea appears to be fairly active and has been mildly beneficial, as has hormonal therapy with progesterone antagonists. Thus, early diagnosis and management are essential to reduce neurological compromise and imprdaove the survival rate of patients with brain tumors.