الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Meningioma is one of the most common primary brain tumors with an incidence of 20% of all primary braintumors.
Meningiomas originate from arachnoid CAP cells along the whole neuroaxis which leads to wide spectrum of localization.
In our study we operated upon 30 patients with the oldest was 70years old and the youngest was 16years old, with mean age of 49.23years 21 females and 9 males, according to the complaint the most common was headache in 20 cases, followed by fits in 12 cases, then weakness in 6 cases, and mental and behavioral changes in 5 cases, and vision changes in 4cases.The lesion was totally removed in 24 cases and subtotal in 6 cases. Among these 30 patients 22 patients improved, 7 patients remained the same, and one patient deteriorated. Among the 30 patients two patient complicated by CSF leak and 4 patients complicated by wound infection, and only two patients showed increased weakness, As for the pathology 7 cases with transitional meningiomas, 4 cases fibroblastic meningiomas, 2 cases with atypical meningiomas, 9 cases meningiothelialmeningiomas, 5 cases psammomatusmeningiomas, 3 cases mixed meningiomas.
The use of both computerized tomography and magnetic resonance imaging was found to be mandatory and none of them can replace the other for proper and accurate diagnosis and visualization of these meningiomas preoperatively. Both together give a clear idea about the location of these meningiomas and their relation to the surrounding neurovascular structures allowing planning of the best surgical approach and emphasizing the important risky points to be properly handled during surgery. The choice of surgical approach remains that of surgeon guided by tumor nature and many other factors. Although these approaches were found to be extremely satisfactory when properly selected, every effort should be done for applying the minimally invasive approaches as well as key-hole surgery whenever appropriately indicated and with the availability of their modern technical instrumentations and adjunctive image guidance.
Conclusion
Vast majority of intracranial Meningiomas are benign and total excision of the lesion should be the mainstay of surgical strategy to prevent recurrence, improve quality of life andmake the patients disease free.
This study included thirty patients harboring meningioma originating from the different parts of the brain. Despite the peculiar characteristics of each of these tumors concerning the described anatomical location, symptoms, vascular supply, and biological behavior, still these tumors share too many aspects regarding their location and surgical management.
The leading symptoms of our study in a descending order of frequency included, headache ,seizures, mental and personality changes,and progressive visual loss. Some patients may present with more than one symptom.These tumors need to be properly investigated by both CT and MRI of the brain. This study proved that they are complementary and none of them could replace the other. Formal cerebral angiography is preserved for selected cases,especially when preoperative embolization is planned.
The microsurgical techniques are fundamental and of utmost importance in preserving the vascular and neural structures present in this region.
In summary,meningiomas are benign extra axial CNS tumors, which when symptomatic are typically treated with definitive resection. However, small asymptomatic meningiomas may be observed and followed by sequential MR and CT imaging.