How to properly understand meningioma

       Meningiomas are divided into intracranial meningiomas, which are formed by intracranial arachnoid cells, and ectopic meningiomas, which occur in tissues and organs not covered by meninges and evolve mainly from residual arachnoid tissue from the embryonic period. The preferred sites are the scalp, skull, orbit, sinuses, trigeminal hemimelia, and the outer layer of the dura mater. Among intracranial tumors, meningioma is the most common benign intracranial tumor after glioma, accounting for 15% to 24% of intracranial tumors.  The etiology of meningioma is not completely clear so far. Clinical findings suggest that cranial trauma, viral infection, radiation exposure, genetic factors or endogenous factors such as hormones and growth factors may be one of the factors in the formation of meningioma. Meningiomas can be found in any part of the skull, but are more common supratentorially than infratentorially, about 8:1. The most common sites are the convex surface of the brain, parsagittal sinus, pars falciformis and skull base (including pterygoid crest, olfactory groove, oblique area, pontocerebellar angle, etc.), thus compressing the functional areas and cranial nerves in the corresponding areas and producing corresponding clinical symptoms and signs.  Benign meningioma grows slowly and has a long course. The average time for early symptoms to appear is about 2.5 years, and in the longest cases, it can take up to 6 years. Generally speaking, the average annual growth volume of tumor is 3.6%. Due to the swelling growth of tumor, patients often have headache and epilepsy as the first symptoms, and depending on the location of tumor, they may have proptosis, vision, visual field, smell or hearing disorder and limb movement disorder. Epilepsy is the first symptom in elderly patients.  If the tumor grows to both sides, bilateral weakness of limb muscles and urination disorder, epilepsy and intracranial pressure increase may occur.  3.Surgery Meningioma is a potentially curable tumor, and surgery can cure most meningiomas. Factors affecting the type of surgery include the location, preoperative cranial nerve injury (posterior cranial recess meningioma), vascular structure, invasive venous sinus and encapsulated artery. Partial resection should be chosen if the patient is asymptomatic and there is a risk of unacceptable functional loss with total tumor removal. For meningiomas of the convex surface of the brain, total resection of the tumor and removal of the involved dura should be pursued to reduce the chance of recurrence. Meningiomas in the medial pterygoid, orbit, sagittal sinus, ventricles, pontocerebellar horn, optic nerve sheath, or slope may be difficult to completely resect. For cavernous sinus meningiomas, the risk of injury to the cranial nerves and internal carotid artery is taken into account, and surgical treatment is demanding, usually by gamma knife. Surgery reverses most neurological signs The patient is awake soon after successful completion of the surgery and has better movement of the left limb than before surgery. He was discharged from the hospital after about a week. Regular follow-ups will follow. The possibility of recurrence is small, and even if it does recur, it can be detected and treated in time.