Re: Cavernous Sinus Meningioma

Posted By CCF NEUROSURGERY MD on October 09, 1997 at 09:55:19:

In Reply to: Cavernous Sinus Meningioma posted by Jill Abrahamson on October 05, 1997 at 08:40:44:







: I was diagnosed one year ago with a meningioma in my right cavernous sinus that affects my vision when looking to the right, tingling on the right side of my face, and prolonged "Head Rush" feelings.
I was diagnosed July 96...symptoms lasted 6 months with gradual disappearance. Four MRIs since Jul 96 show no change in lesion size.  It is touching, but not encasing, the carotid artery.
Symptoms have now come back (Sept 97).  Have not had an MRI since Jun 97.  MRI in Jun showed no growth, lesion is on the carotid artery but not encasing.
I am told symptoms are due to inflamation (inflammation).  Do you agree?
-Signs are deficit in vision when looking to the right, tingling R side of face (mostly along nose and around mouth)
-Tingling is more pronounced when laying down.
In addition, below symptoms are more pronounced than they were in '96:
-Feel like I have a hangover every morning when I wake up.
-Lightheadnesses periodically throughout the day.
-Sometimes I feel like i'm "losing time" (periods of few minutes)
It's been about 3 weeks since onset of these symptoms...they again feel like they are gradually clearing up.
Also would welcome an internet chat with anyone who has similar tumor.
  
Thanks, Jill



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Dear Jill,
Meningiomas are benign tumors of the coverings of the brain.  They are slow
growing and are usually followed clinically until they cause a neurological
problem.  Apparently, the MRI showed that you have a meningioma in the right
cavernous sinus.
The cavernous sinus is a part of the venous drainage system of the head.  
It contains the carotid artery and four cranial nerves which control things
such as eye movement and facial sensation.  The cavernous sinus has traditionally
been a region that presents surgical difficulties due to the anatomy of the
area.  Recent advances in microsurgery have helped tremendously in operating
in this region.
Your particular tumor, from what you describe, is beginning to press on some
of the cranial nerves in the cavernous sinus.  The tumor will continue to
grow slowly over time and cause further compression of local structures.
At some arbitrary point you and your surgeon may decide that something must
be done.  The options include further observation, radiation and formal
surgery.  You should discuss the situation with your neurosurgeon in light
of your present symptoms and consider the options mentioned above.
The Cleveland Clinic is experienced in both the surgical and radiotherapy
options.  A second opinion to discuss options and the attendant risks of
each may be wise.  An appointment can be made with a staff neurosurgeon
can be made by calling 216-444-5672.  Should you choose to visit, your most
recent MRI scans would be essential to the evaluation.  
Good luck.