1. Extra-axial Neoplasms
Meningiomas account for 15% of all intracranial tumors and are the
most common extra-axial tumor. They originate from the dura or
arachnoid and occur in middle-aged adults. Women are affected
twice as often as men. Meningiomas are well-differentiated, benign,
and encapsulated lesions that indent the brain as they enlarge. They
grow slowly and may be present for many years before producing
symptoms. The histologic picture shows cells of uniform size that
tend to form whorls or psammoma bodies.
The parasagittal region is the most frequent site for meningiomas,
followed by the sphenoid wings, parasellar region, olfactory groove,
cerebello-pontine angle, and rarely the intraventricular region.
Meningiomas often induce an osteoblastic reaction in the adjacent
bone, resulting in a characteristic focal hyperostosis. They are also
hypervascular, receiving their blood supply predominantly from
2. Meningioma: CT Imaging
– Sharply Circumscribed
– Hyperdense (+/- Ca++)
psammoma bodies !
– Broad Dural Surface
– Bone Changes
Meningioma: Vasogenic Edema
– parasitization of MCA, etc.
– compression of cortical
– Close apposition of tumor to
– Thinned cortex
– +/- infiltration of brain
– Fluid gradient from
meningioma into brain
3. Dural Tail
First reported to
be neoplastic invasion
What is it REALLY?
– Thickening of the dura
– Vasocongestion of the
– Edema of the dura
Prevalence of "dural tail sign"
Rokni-Yazdi H, Sotoudeh H. Eur J
22/98 patients (22.44%) of
masses had "dural tail sign“
– 18 meningiomas
– 2 pituitary adenomas
– 1 primary cerebral lymphoma
The "dural tail sign" had a
58.6% and specificity of 94.02%
diagnosis of meningioma.