orbital meningioma
Introduction
Introduction to orbital meningioma Meningiomas are benign tumors that occur in meningeal cells and occur in the brain and are relatively rare in the sputum. The tumor that occurs in the sputum originates from the optic nerve sheath meningeal, called the optic nerve sheath meningioma, which occurs in the periosteum of the sphenoid or frontal bone wall, called the sphenoid bone or frontal bone meningioma. There are also very few patients with ectopic meningeal cells in the sputum. The incidence rate for men and women is about 1:2, and adulthood is good. Most of the tumors are endothelial and fibrous. There are two kinds of tumor growth methods. One is expansive growth, which is nodular, with narrow pedicles, larger, and relatively easy to operate. Another kind of growth, It is carpet-like and has extensive adhesion to the dura mater of the skull base. It is difficult to completely cut the operation and forms different clinical manifestations according to its growth characteristics. basic knowledge The proportion of illness: 0.0054% Susceptible population: the incidence rate of adult males and females is about 1:2 Mode of infection: non-infectious Complications: eye movement disorder cerebral infarction
Cause
Causes of orbital meningioma
Cause:
Most of the tumors are endothelial and fibrous. There are two kinds of tumor growth methods. One is expansive growth, which is nodular, with narrow pedicles, larger, and relatively easy to operate. Another kind of growth, It is carpet-like and has extensive adhesion to the dura mater of the skull base. It is difficult to completely cut the operation and forms different clinical manifestations according to its growth characteristics.
Prevention
Orbital meningioma prevention
Improving the body's immunity against tumors can help to strengthen and strengthen the body's immune system and cancer.
Avoiding harmful substances (promoting factors) can help avoid or minimize exposure to harmful substances.
The most important thing to improve the function of the immune system is: diet, exercise and control troubles, healthy lifestyle choices can help stay away from cancer. Maintaining a good emotional state and proper physical exercise can keep your body's immune system at its best, and it is also good for preventing tumors and preventing other diseases.
Complication
Orbital meningioma complications Complications, eye movement disorders, cerebral infarction
Complications of sphenoid ridge meningioma
There may be some complications after craniotomy:
1. Physical motor dysfunction, excessive traction or vasospasm affects the motor center.
2. Sports aphasia, caused by excessive traction in the lower part of the frontal lobe.
3. Cranial nerve function damage, hemorrhage hemianopia, blindness, eye movement disorder, the first dysfunction of the trigeminal nerve.
4. Cerebral infarction, internal carotid artery, middle cerebral artery, anterior cerebral artery or lateral vascular injury, caused by sputum.
5. Subthalamic lesions, caused by direct injury or ischemia during surgery.
Once the above complications occur, treatments such as microcirculation drugs, neurotropic drugs, energy mixture agents, dehydration drugs, hyperbaric oxygen chambers and symptomatic treatment should be actively provided.
Symptom
Eyelid meningioma symptoms Common symptoms Visual impairment Visual field of vision changes eyeballs
1. In the early stage of optic nerve sheath meningiomas, only vision loss, visual field changes and so on. A small number of tumors are eccentrically growing, and vision changes can occur until later. The eyeballs are slowly progressing. Fundus changes: tumors occur in the front of the optic nerve, early can be expressed as optic disc uplift, borders are unclear, gray-white. Occurred in the posterior, optic atrophy in the early stage, secondary edematous atrophy, more characteristic. The optic nerve is characterized by long-term venous hypertension, collateral circulation between the central retinal vein and the choroidal vein, that is, the ciliary vein.
2. Meningioma that occurs in the periosteum of the sphenoid bone often shifts the eyeball inward and downward. A diffuse bulge of the temporal side may occur when the tumor is large.
Examine
Eyelid meningioma examination
1. The quadruple of the optic nerve sheath meningiomas is characterized by lateral ocular protrusion, loss of vision, chronic edematous optic disc atrophy and visual ciliary vein.
2. X-ray examination of optic nerve sheath meningioma to the intracranial spread of X-ray can show optic canal enlargement. The meningioma that occurs in the periosteum is more involved in the sphenoid bone and the small wing. The X-ray shows bone hyperplasia, increased density, and blurred edges.
3. Ultrasound exploration of optic nerve sheath meningioma can show obvious thickening of the optic nerve, the boundary is still clear, the internal echo is less, the distribution is irregular, the attenuation is significant, and occasionally the strong echo spot.
4. CT scan
(1) Optic nerve sheath meningioma can show that the optic nerve is thickened into a tubular, beaded, fusiform, conical, etc., some patients can show a typical "railway sign", the enhancement is more obvious. When the tumor is eccentrically grown, it may be round or irregular.
(2) Meningiomas that occur in the periosteum may show hypertrophy, increased density, burr-like or phagocytic destruction of the surface of the bone. CT scan of the bone window is particularly clear, involving large sphenoid bones and small wings. A soft tissue mass in the iliac crest is also visible in the adjacent bone of the lesion, which is flat and the border is unclear.
5. MRI scan of optic nerve sheath meningiomas showed moderate to low signal on T1WI and medium and low signal on T2WI, and the signal was homogeneous. The use of fat suppression and enhancement technology can significantly enhance the tumor, typical can be "vehicle track", and especially suitable for the observation of intracranial spread of the tumor, can be found in the saddle area to significantly enhance the abnormal signal. The bone components in sphenoidal meningioma showed low signal on both T1WI and T2WI. The tumor spreads along the intracranial dura mater, forming a "brain tail" sign.
Diagnosis
Diagnosis and differentiation of orbital meningioma
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Optic glioma is more common in childhood, with slow vision loss and even loss of vision. Imaging examination can show that the optic nerve fusiform thickening, tumor can have cystic changes, without bone hyperplasia and intraorbital soft tissue mass is an important basis for meningioma.
2. Lacrimal gland malignant tumors Adenoid cystic carcinoma and other malignant tumors often spread along the outer wall of the iliac crest to the tip of the iliac crest, and even invade the intracranial, and need to be differentiated from sphenoidal meningioma.
3. Orbital metastatic tumor The sphenoid bone wing bone is a good site for the transfer of systemic malignant tumors to the eyelids. The bone destruction is severe, often accompanied by soft tissue masses. The patient's general condition is poor, the cachexia is good, and the condition progresses rapidly.
