Meningioma of the lateral 1/3 of the pterygoid crest. The lateral type of meningioma of the pterygoid crest presents late, with the tumor occurring on the large wing of the pterygoid bone, causing bone growth in the posterior lateral wall of the orbit and the temporal area, resulting in orbital shrinkage, or the tumor invading directly into the orbit, resulting in proptosis of the eye. How to check for orbital shrinkage? The clinical presentation of pterygoid crest meningioma depends on the location of the tumor. In the medial type, early symptoms are obvious, and patients may show brain nerve compression, such as vision loss. If the tumor invades into the orbit or the supraorbital fissure, the patient may have symptoms such as protrusion of the eyeball if the ocular venous return is obstructed. Patients with medial type may also have symptoms of II, IV, VI and V branch 1 brain nerve damage. Psychiatric symptoms and olfactory disturbance are mostly seen in patients with tumor growth in the anterior cranial fossa, but are less common. Lateral pterygoid crest meningioma presents late, with early headache and lack of localization signs. Some patients may present with temporal lobe seizures and zygomatic-temporal bone bulge if the tumor invades the temporal bone. When the tumor grows larger in both types of patients, it will cause muscle weakness of the contralateral limb and increase of intracranial pressure. Based on the clinical manifestations, combined with CT and MRI, the clinical diagnosis can be made clearly in general. The adjacent relationship between tumor and major blood vessels. The blood supply artery of medial type pterygoid crest meningioma mainly comes from the branch of ophthalmic artery. If the tumor develops in the anterior cranial fossa, the blood supply of anterior sieve artery can be seen, and the siphon bend of internal carotid artery can be seen. In lateral type pterygoid crest meningioma, the blood supply mainly comes from the external carotid artery branches, such as the middle meningeal artery, which appears as typical radial tumor vessels, and the tumor staining is more obvious in the venous stage than the arterial stage. The middle cerebral artery is generally elevated in the lateral image due to tumor compression. If external carotid artery supply is seen at the same time of cerebral angiography, vascular embolization can be performed at the same time to reduce surgical bleeding.