Re: Cavernous Sinus Meningioma

Posted By CCF Neurosurgery MD on October 20, 1997 at 12:57:06:

In Reply to: Cavernous Sinus Meningioma posted by Jill  on October 19, 1997 at 10:05:03:







: I have a lesion in the right cavernous sinus that is touching the carotid artery.  Lesion diagonosed as Meningioma base on MRI.
-Onset of symptoms in Jul 96 with gradual clearing by Dec 96. (Details in my previous email)
-Basically symptom-free (For 9 Months) until Sep 97--again with gradual clearing up of symptoms
-I've had 4 MRIs in the last year...all show the lesion HAS NOT CHANGED SIZE
including the one just done on Oct 17.

I'M TOLD THE SYMPTOMS REAPPEAR BECAUSE OF INFLAMATION (inflammation) OR WATER RETENTION....TO ME IT SEEMS MORE
CONSISTENT WITH SOME SORT OF SMALL HEMORRAGING.  OBVIOUSLY THE LESION DOES NOT CAUSE THE SYMPTOMS BECAUSE IT HAS NEVER CHANGED SIZE--IT IS ONLY A BIT OVER 1 CM.
I CAN UNDERSTAND THE CONCEPT OF FLUCATION..BUT DON'T THINK INFLAMMATION OR WATER RETENTION TAKES
A 9 MONTH HOLIDAY.  I HAVE NOT BEEN ABLE TO FIND ANY CASES ON THE INTERNET THAT SHOW THIS TO BE THE
CASE..FOLKS THAT HAVE SYMPTOMS LIKE MINE TEND TO HAVE ARTERIOVENOUS MALFORMATIONS.
GIVEN THE HISTORY--DO YOU AGREE THAT IT, WHATEVER IT IS, MAY BE BLEEDING?
and,,,Just as an aside and probably unrelated, today I had what is called an "eye migraine" -- lasted only about 10 minutes with a portion of my left visual field being blocked out.
Thanks again for your opinion..Jill

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Dear Jill,
It is unusual for a meningioma to bleed.  Again, these are mostly benign tumors that
will grow slowly over time and cause compression of local structures.  Likewise,
meningiomas tend not to have much swelling associated with the tumor mass.  
Though it is conceivable that either bleeding or swelling may be seen, it
would be considered unusual.  Regardless, both of these things may be easily
seen on the MRI scans that were done recently.
The difficulty you had with vision could be from tumor pressing on the optic
nerve.  Again, the MRI would be useful in relating your symptoms to the tumor
mass.
You need to speak to your neurosurgeon about whether he or she thinks the
tumor is causing your symptoms.  If so, you may consider one of the options
discussed in the previous reply.  If there was indeed some swelling in the
area on MRI, a trial of steroids would be reasonable.
Good luck.