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MRI revealed parfalcine extra-axial enhancing mass close to the vertex. Why is there loss of memory?

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Neurologist, Surgical
Practicing since : 1996
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I just found out via an MRI w and wo contract that I have a left parfalcine extra-axial enhancing mass close to the vertex with findings most consisent with meningioma. there is no edema, no other enhancing masses evident, no evidence of acute ischemia, hemorrhage or hydrocephalus. it is 1.4 x 1.1 x 1.4 in the AP, transverse and craniocaudal dimensions. Where is this located? Is this a big tumor or one that is in a tricky location? I'm going to see a neurosurgeon on Monday. How soon do they usually take action on a tumor like this? What would be a typical course of action? I have already shown signs of headaches, loss of memory, difficulty thinking, speech..
Posted Wed, 23 May 2012 in Stroke
Answered by Dr. Praveen K Nath 10 hours later

Thanks for the query.

I have gone through your history in detail.

We call that area of the brain which abuts the midline as parafalcine area. You have a small tumour as described in the scan (left parafalcine meningioma of 1.4x1.1x1.4 cms). It is a small mass and can be managed depending on clinical assessment of the patient and the appearance on contrast Magnetic Resonance Imaging (MRI) of brain scan.

I would encourage you to consult your neurosurgeon at the earliest. Your surgeon will be able to assess your general condition as well as assess the actual size and vascularity of tumour as seen on MRI. He/she then can manage this condition in the following ways:

1. You will be started on medications such as anticonvulsants, antioedema measures, steroids, analgesics, etc. to relieve your symptoms.

2. He/she may choose to wait and watch. If you become asymptomatic after the initial treatment or if you are unfit for surgery, we can continue to monitor the progress of the tumour by means of repeated scans.

3. Choose to treat you with "Gamma Knife treatment (radio surgery)". Left parafalcine meningioma of your size can be managed nicely with this gamma knife treatment. It is the safest method.

4. Next best option is open craniotomy surgery & excision of tumour

I hope this answers your query. Feel free to contact me for any further query, I will be glad to assist you.

Wish you good and speedy recovery.

Best Regards
Dr Praveen K Nath XXXXXXX Consultant Neurosurgeon
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