The clinical presentation and pathological characteristics of 18 meningiomas among 240 surgically verified intracranial space-occupying lesions in children are reported from the Depts of Neurosurgery and Pathology, National Inst of Mental Health, Bangalore and Nizam’s Inst of Med Sciences, Panjagutta, Hyderabad, India. The tumor location was supratentorial in 15, infratentorial in 2, and intraorbital in 1 patient. The majority presented between 11-15 years of age and the sexes were equally affected. The most common presenting symptoms were headache in 11 and vomiting in 4 patients; hemiparesis, deteriorating vision and seizures were early manifestations in 3, 3 and 2 patients, respectively. The duration of symptoms before diagnosis was less than 1 month in 50% patients. The meningiomas were large, 4 showed sarcomatous change, 6 were cystic, and one recurred, requiring 3 operations. Two patients died postoperatively. [1]

COMMENT. Meningioma is an uncommon intracranial tumor of childhood, accounting for less than 5% in previous reports and 7.5% in the above study. In some larger series, the incidence is quoted at 0.4-1.5%. Contrast CT is usually superior to MRI in radiologic diagnosis [2]. CT can distinguish orbital meningioma from optic nerve glioma in about 75% of cases. In the remainder, angiography shows a tumor blush with meningioma, a finding that is absent with optic nerve glioma. [3]

Proptosis was an early presenting sign of orbital meningioma in the present study, leading to prompt diagnosis, whereas this manifestation was late in appearance in the following case-report of multiple meningiomas.