Thanks to advances in screening technology, the detection rate of meningiomas has increased. What should I do once I find out I have a meningioma? First step, don’t be nervous! Learn a few things about meningiomas. Meningioma is the most common intracranial “benign tumor” in adults, accounting for 14.3% to 19% of primary intracranial tumors. The peak age of onset is around 45 years old, with a male s female rate of 1s 1.8. Meningiomas are associated with the arachnoid membrane and can occur in any area where arachnoid cells are present (between the brain and skull, within the brain, along the spinal cord), especially in areas where arachnoid granules are concentrated. Meningiomas are most often associated with the dura mater, but they can also occur without association with the dura mater, as in meningiomas that occur in the ventricles. Meningiomas are usually slow-growing, well-defined (non-invasive), benign lesions. They may be malignant and/or rapidly growing in a small number of cases. 8% of patients have multiple tumors, especially in patients with neurofibromatosis. Occasionally the tumor grows in a large prostrate pattern (plaque meningioma). The second step is to address the diagnostic question of whether the tumor is really a “meningioma”. Many patients have only a mild headache, or even a meningioma discovered incidentally on a CT scan. Because of the slow growth of the tumor, the tumor is often very large and the clinical symptoms are not yet severe. Sometimes, the patient’s fundus optic papillary edema is already quite pronounced, and even secondary optic atrophy occurs, while the headache is not severe and there is no vomiting. It is worth noting that when the tumor in the “dumb zone” grows so large that it cannot be compensated and the intracranial pressure increases, the condition will suddenly deteriorate and even brain herniation will occur in a short period of time. The diagnosis can be confirmed by CT and MRI examination. 1, CT can see uniform density of lesion, enhancement is obvious, basal width attached to the dura mater. CT non-enhanced scan value of 60-70 is often accompanied by sand-like tumor calcification. There is usually no obvious cerebral edema, but a few of them may be accompanied by obvious peritumoral edema, and sometimes the scope may reach the whole cerebral hemisphere. The advantage of CT is that it can clearly show the calcification and bony changes (hyperplasia or destruction) of the tumor. On MRI, it generally shows equal or slightly longer T1 and T2 signals. 60% of the tumors have equal signal with gray matter on T1 image and 30% have low signal below gray matter. On T2 image, 50% are equal signal or high signal, 40% are moderate high signal, and may be mixed signal. The tumor is well-defined, round or round-like, and most of the edges have a low-signal band in an arc or ring shape for the residual subarachnoid space (cerebrospinal fluid). The parenchymal part of the tumor shows homogeneous and obvious enhancement after venous enhancement. MRI has the advantage of clearly demonstrating the relationship between the tumor and the surrounding soft tissue. The disappearance of the subarachnoid interface between the meningioma and the brain indicates that the tumor is growing aggressively, making total surgical resection more difficult. 3. Dural enhancement at the base of the tumor can form the “meningeal tail sign”, which is a characteristic manifestation of meningioma, but not a unique imaging manifestation of meningioma. Other lesions adjacent to the dura, such as metastatic carcinoma and glioma, may also have similar imaging features. 4. Simultaneous CT and MRI enhancement scans and comparative analysis can lead to a more correct localization and qualitative diagnosis. The third step is to find a professional physician and perform surgery. Surgical removal of meningioma is the most effective treatment. With the development of microsurgical techniques, meningioma surgical results continue to improve, allowing most patients to be cured, but the possibility of recurrence cannot be ruled out. For meningiomas and malignant meningiomas that cannot be completely resected, radiation therapy is required after surgery. Radiation therapy is effective for malignant meningiomas and vascular ependymal meningiomas. However, care should be taken to avoid side effects such as radiation damage.