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A 51-year-old female patient was referred with left-sided proptosis, visual loss, and pain due to a sphenoid wing meningioma. She had undergone a craniotomy for resection of the intracranial component of a grade 1 meningioma 3 months prior to her referral.

photo credit: Phovoir/Shutterstock


Please use the discussion feature below to ask the authors your questions and provide further feedback on others’ questions. All questions and replies are moderated.


  1. Paulo Saraceni

    First of all is mandatory to perform a complete neurologic exam in order to find any other deficit on cranial nerves. I would pay special attention on ocular movements. Also an nasal endoscopy and an otoscope should be done, as we have a strength association between tumors at sphenoid wing and temporal bone either. And the first image exam that I would ask for would be a contrasted CT of skull, temporal bones and paranasal sinus.

  2. Firas

    1-what’s the duration of her complain?
    2-pre and post craniatomy radiological investigation?
    3-symtomes do not settle(may be incomplete removal

  3. Darlene

    Her symptoms started 7 months prior to being seen, in Sept 2015. She presented to the clinician with otalgia in Sept 2015, then developed decreased vision and proptosis in Dec 2015

  4. Professor Shakil Aqil

    What was the duration of her symptoms before the surgery?
    Need to see post op MRI SCAN with contrast and also CT Scan of the sinuses to see the extent of residual tumour.
    Since she had removal of intracranial part of hemangioma she would still have residual tumour around or in sphenoid sinus,optic nerve,cavernous sinus and orbital apex
    So before deciding further plan need to see the scans I have mentioned

  5. Gil M. VICENTE

    I will order an MRI at this point, If this was done , what is the resilt?


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