[X-ray diagnosis of meningiomas in childhood and adolescence]

In a period of 15 years, 16 intracranial meningiomas of the childhood and adolescence were examined radiologically. The neuroradiological findings obtained are analysed and compared with those obtained in adults. The particularities resulting from this comparison, which above all concern the angiographic picture of meningiomas in juvenile patients, are worked out and discussed. As a result, some conclusions can be drawn which may be of practical importance: As is the case with other cerebral tumours in childhood, meningiomas in most cases give rise to reliable radiological signs of an increase in intracranial pressure. The changes of the cranial bones indicating the presence of a meningioma, which are well-known signs in adults, are found in children almost as frequently. While pneumo-encephalography in most cases permits a reliable localisation of the tumour, it does not permit a diagnostic statement with respect to the kind of the tumour. In three patients the air filling made larger cysts visible which obviously occur more frequently in children than in adults. The angiographic picture of meningiomas in childhood often differs from that in adults with regard to the vascularisation type as well as the phase course, so that differential-diagnostic difficulties may arise. However, when considering the above mentioned peculiarities of the vascular picture of memingiomas in children, it appears to be possible to make a preoperative diagnosis of the kind of the tumour with the help of the angiogram also for children. The increased vascular supply via branches of the A. carotis externa, which is frequently found in neningiomas, cannot in our opinion be considered as a decisive type-diagnostic criterion; it must be considered as an expression of an increased participation of the dura and thus also occurs in other space-occupying intracranial processes.