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Cranial and Spinal Meninges01:19

Cranial and Spinal Meninges

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The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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Isolated Intraconal Meningioma.

Mohammad Taher Rajabi1, Kasra Cheraqpour1, S Saeed Mohammadi1,2

  • 1Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Journal of Ophthalmic & Vision Research
|November 29, 2021
PubMed
Summary

This case report details a rare instance of an isolated intraconal meningioma, a tumor that presented as painless proptosis. Postoperative histopathology confirmed the diagnosis, highlighting the need for consideration in differential diagnoses.

Keywords:
Intraconal MeningiomaOrbital MeningiomaPrimary MeningiomaEctopic Meningioma

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Area of Science:

  • Ophthalmology
  • Neuropathology
  • Neurosurgery

Background:

  • Orbital meningiomas are rare tumors, with ectopic presentations being exceptionally uncommon.
  • Intraconal masses can present diagnostic challenges, often mimicking more common orbital pathologies.

Observation:

  • A 24-year-old pregnant woman presented with progressive, painless left eye proptosis.
  • Magnetic resonance imaging (MRI) revealed an intraconal mass with signal characteristics suggestive of cavernous hemangioma.
  • Surgical findings and subsequent histopathology unexpectedly identified a meningotheliomatous meningioma.

Findings:

  • The intraconal mass exhibited hypointense signals on T1-weighted and hyperintense signals on T2-weighted MRI sequences.
  • Gross surgical features were inconsistent with the initial suspected diagnosis of cavernous hemangioma.
  • Postoperative histopathology definitively diagnosed meningotheliomatous meningioma.

Implications:

  • Ectopic orbital meningiomas are challenging to diagnose preoperatively and require histopathological confirmation.
  • These rare tumors should be included in the differential diagnosis for intraconal masses with specific MRI signal characteristics.
  • Accurate diagnosis is crucial for appropriate management and patient outcomes in orbital tumors.