42yrs old male having C/o GME since 4 months ,headache,Vomitting,left sided localized became generalized,No comorbidy All investigations are normal.Diagnosis and approach??




Axial T1 w image demonstrate a hypodense dural based mass in th Rt parietal parasagittal region.A rim of T2 hypointense signal between the mass and adjacent effaced rt parietal lobe is consistent with CSF cleft, confirming the mass is extra Axial(film 3/ 8 3rd row 5th film).T1w post contrast image demonstrates avid homogeneous intralesional enhancement of the interhemispheric sure This dural " tail" is better appreciated on the coronal post contrast T1W image Diagnosis - Meningioma

Valuable opinion

There is nothing called parietal meningioma. When u say parietal u mean an intra axial tumor. Meningioma is an extra axial tumor and is not classified according to lobes. It is also not a convexity meningioma because its base is arising from the dura of sagittal sinus.

Sir, if it doesn't include convexity, how is it visible in axial image

Axial T1w image demonstrates a hypointense dural based mass in the right parietal parasagittal area. A rim of T2 hyperintensity noted between the mass and the subject effaced parietal lobe is consistent with CSF cleft, confirming the mass is extra axial( 3/ 8 set 3rd row 5th film.Pist contradt T1w image demonstrates avid homogeneous intralesional contrast enhancement with associated thickening and enhancement of the interhemispheric sure. The dural " tail " is better seen on coronal post contrast T1W image. Diagnosis Meningioma

Right Parietal Meningioma.

Valuable opinion

Agreed with @Dr. Neeraj Basantani . Thanks for the tag @Dr. Prashant Vedwan .

Parasaggital meningioma.Craniotomy with excision done.

It's parietal huge extra axial SOL requires excision of the lesion Probably meningioma

Parasagittal meningioma. Requires craniotomy and excision. One has to be careful of sagittal sinus

Parasagittal meningioma Total Excision possible

Kindly refer to me in agra if no one is ready to operate. Meanwhile u can start mannitol, dexamethasone and phenytoin

Sir,sucessfully operated

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