White matter buckling: CT sign of extraaxial intracranial mass

George, Ajax E.; Russell, Eric J.; Kricheff, Irvin I.

doi:10.2214/ajr.135.5.1031

Cited by 15 publications

(3 citation statements)

References 13 publications

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“…Extra-axial masses include meningiomas, schwannomas, metastatic lesions, arachnoid cysts, epidermoids, dermoids, chordomas, and eosinophilic granulomas 5,15) . The characteristic radiological features differentiating extra-axial from intra-axial masses include local bone changes, white matter buckling (inward compression of the gray-white junction), pseudocapsule (signal void of the dura or displaced vessels), CSF cleft (CSF or cortical vessels entrapped between the tumor and underlying cortex), and dural tail sign (enhancement of the dura infiltrating away from the lesion) 2,5,6,9,15) . Glioblastomas typically present as invasive intra-axial masses with irregular margins.…”

Section: Discussionmentioning

confidence: 99%

Glioblastoma Presenting with the Radiological Features of a Meningioma: A Case Report and Literature Review

Song,

Lee,

Ryu

et al. 2024

Nerve

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Glioblastomas, which are the most common primary malignant brain tumors in adults, occasionally exhibit radiological features similar to those of other diseases. However, instances of them mimicking meningiomas are rare. This article describes a rare case of a glioblastoma presenting with radiological features similar to those of a meningioma. A 55-year-old man was admitted following 2 months of gait disturbance, mild dysarthria, and dizziness. Magnetic resonance imaging suggested an extra-axial tumor in the interhemispheric fissure exhibiting a cerebrospinal fluid cleft sign, which was indicative of a meningioma. Bifrontal craniotomy for tumor resection revealed a highly vascularized, yellowish-gray friable mass within the interhemispheric fissure. The pathological diagnosis was glioblastoma. The patient’s symptoms improved following treatment with whole-brain radiotherapy and temozolomide chemotherapy, and his condition was stable during a 5-month follow-up period. Glioblastomas may present with radiological features similar to those of meningiomas, making it challenging for physicians to establish an accurate diagnosis and effective treatment plan.

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Section: Discussionmentioning

confidence: 99%

Glioblastoma Presenting with the Radiological Features of a Meningioma: A Case Report and Literature Review

Song,

Lee,

Ryu

et al. 2024

Nerve

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“…45 Defining a mass as intra-axial or extra-axial opens up 1 set of Figure 10. Intraaxial means that a lesion is within the substance of the brain and spinal cord itself, and extra-axial encompasses every other localization.…”

Section: Brainmentioning

confidence: 99%

Neuroimaging for the Nonradiologist

Libfeld

2015

International Anesthesiology Clinics

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Neuroimaging interpretation is truly an art. One of the prerequisites for effective neuroimaging interpretation is a solid understanding of neuroanatomy, which is both complex and intricate. Building upon a foundation of neuroanatomy, a detailed knowledge of pathophysiology is required. One must also have a command of various imaging modalities to correctly apply anatomic and pathophysiological information. This includes an understanding of the physics behind each modality, which will in turn aid in knowing a particular modality's strengths and weaknesses. Blending all of these skills together to make an accurate interpretation while keeping a particular clinical scenario in mind is where the art of neuroimaging is applied. Mastering this process is obviously something that takes years of proper training, meticulous attention to detail, and a background of clinical experience. It is difficult to distill this art form into a small nugget of all-encompassing knowledge; however, a few introductory concepts will go a long way toward improving one's ability to glean useful clinical information from neuroimaging studies. ' AnatomyRegardless of the modality employed, a solid base of anatomic understanding is critical for correct image interpretation. Modalities may evolve and change, but anatomy is constant. This lends an alternate meaning to Sigmund Freud's saying "Anatomy is destiny."A neuroimager's arena is the central nervous system (CNS). Information regarding the peripheral nervous system as well as head and neck anatomy is beyond our scope. The CNS consists of the brain and the spinal cord. The following sections describe the most salient CNS neuroanatomy.

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“…A useful feature in confirming the extra-axial location of the suspected meningioma is the inward bowing of the gray-white junction of the adjacent brain parenchyma, often called white matter buckling [24]. White matter buckling is especially well visualized on MRI studies because of the superior recognition of the gray and white matter of the superficial brain on MRI examinations (Fig.…”

Section: Meningiomasmentioning

confidence: 99%

Extra-axial brain tumors

Drevelegas

2004

Eur Radiol

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Meningiomas, schwannomas, metastases, maldevelopmental cysts, epidermoids, dermoids and bone tumors represent the vast majority of extra-axial brain tumors. The location of extra-axial brain tumors affects treatment planning and predicts their prognosis. Computed tomography and particularly magnetic resonance imaging are used for diagnosis and localization. In this article, the imaging findings of the extra-axial brain tumors are discussed.Keywords Extra-axial . Brain tumors . MRI . Meningioma . Schwannoma Extra-axial tumors are the tumors of extracerebral location. They are usually benign. The location of brain tumors affects treatment planning and predicts their prognosis. The multiplanar capability of MR imaging makes it the best technique in the evaluation of extra-axial brain tumors. Meningiomas are the most common exta-axial neoplasms in the supratentorial compartment. Other extra-axial neoplasms are: schwannomas, metastatic lesions, arachnoid cysts, epidermoids, dermoids, chordomas and eosinophilic granulomas. MeningiomasMeningiomas are vascular, non-glial tumors of the central nervous system arising from meningothelial (arachnoidal) cells. They generally receive their blood supply from branches of the external carotid arteries, although large tumors will also recruit branches from the internal carotid arteries [1,2]. Meningiomas are the most common non-glial primary CNS tumors and the most common extra-axial intracranial tumors. The relative frequency of meningiomas regarding all intracranial tumors varies between 15% [1, 3, 4] and 20% [1,5,6]. They are encountered in middle-aged adults and are more common in women than in men. Childhood meningiomas are uncommon and represent 1-4.2% of central nervous system tumors and 1.5-1.8% of all intracranial meningiomas [7][8][9][10][11].The presenting signs and symptoms of meningiomas, when neurofibromatosis is excluded, are related to the tumor location and size, they are often non-specific and vague, primarily related to brain compression and edema from the adjacent neoplasm [1,12]. Signs of increased cranial pressure (nausea, headache, vomiting) are found in 50% of the patients. Confusion, focal weakness and seizures are the most common symptoms while paresis is the most frequently found physical sign [1,13,14]. Headache has been reported as the most common single presenting symptom, found in 36%, while normal physical examination has been reported in 26% of patients [12].The most common locations of meningiomas in descending order of frequency are: convexity meningiomas 20-34%, parasagittal 18-22%, sphenoid and middle cranial fossa 17-25%, frontobasal 10% and posterior fossa 9-15%.

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White matter buckling: CT sign of extraaxial intracranial mass

Cited by 15 publications

References 13 publications

Glioblastoma Presenting with the Radiological Features of a Meningioma: A Case Report and Literature Review

Glioblastoma Presenting with the Radiological Features of a Meningioma: A Case Report and Literature Review

Neuroimaging for the Nonradiologist

Extra-axial brain tumors

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