Table: Symptoms of Meningiomas by Site-Merck Manual Professional Edition

Symptoms of Meningiomas by Site

Site	Findings
Base of skull	Visual loss Oculomotor palsies Exophthalmos
Cerebral convexities	Focal seizures Cognitive deficits Ultimately, signs of increased intracranial pressure
Clivus and apical petrous bone	Gait disturbance Limb ataxia Deficits referable to the 5th, 7th, and 8th cranial nerves
Foramen magnum	Ipsilateral suboccipital pain Paresis that begins in the ipsilateral arm and progresses to the ipsilateral leg, then to the contralateral leg and arm Sometimes Lhermitte sign Cranial nerve deficits (eg, dysphagia, dysarthria, nystagmus, diplopia, facial hypoesthesia)
Olfactory groove	Anosmia Sometimes papilledema and visual loss
Parasagittal or falx	Spastic paresis or sensory loss, usually beginning in the contralateral leg, but occasionally bilateral Cognitive deficits
Posterior fossa tentorial tumors that extend superiorly or inferiorly	Hydrocephalus
Sphenoid wing:
Medial (growing into the cavernous sinus)	Oculomotor palsies Facial numbness
Middle (growing anteriorly into the orbit)	Visual loss Exophthalmos
Lateral (as a globular mass or a meningioma en plaque*)	Seizures Headaches
Tuberculum sellae	Visual loss Bone changes sometimes visible with imaging
* Meningioma en plaque involves spread into the dura, with dural thickening and invasion of adjacent bone; the tumor sometimes grows into the temporal bone.

Site

Findings

Base of skull

Visual loss

Oculomotor palsies

Exophthalmos

Cerebral convexities

Focal seizures

Cognitive deficits

Ultimately, signs of increased intracranial pressure

Clivus and apical petrous bone

Gait disturbance

Limb ataxia

Deficits referable to the 5th, 7th, and 8th cranial nerves

Foramen magnum

Ipsilateral suboccipital pain

Paresis that begins in the ipsilateral arm and progresses to the ipsilateral leg, then to the contralateral leg and arm

Sometimes Lhermitte sign

Cranial nerve deficits (eg, dysphagia, dysarthria, nystagmus, diplopia, facial hypoesthesia)

Olfactory groove

Anosmia

Sometimes papilledema and visual loss

Parasagittal or falx

Spastic paresis or sensory loss, usually beginning in the contralateral leg, but occasionally bilateral

Cognitive deficits

Posterior fossa tentorial tumors that extend superiorly or inferiorly

Hydrocephalus

Sphenoid wing:

Medial (growing into the cavernous sinus)

Oculomotor palsies

Facial numbness

Middle (growing anteriorly into the orbit)

Visual loss

Exophthalmos

Lateral (as a globular mass or a meningioma en plaque*)

Seizures

Headaches

Tuberculum sellae

Visual loss

Bone changes sometimes visible with imaging

* Meningioma en plaque involves spread into the dura, with dural thickening and invasion of adjacent bone; the tumor sometimes grows into the temporal bone.