Meningiomas

10-15 years of remaining life expectancy to be "elderly". In addition, observation may be an appropriate option for the following people regardless of their age: (1) patients with certain skull base meningiomas with minimal or no symptoms (e.g. cavernous sinus meningioma causing mild facial tingling or numbness), (2) patients with incidental small tumors with no surrounding edema, and (3) patients who insist on non-intervention after a thorough discussion of all treatment options. However, these patients must be compliant with the necessary radiographic and neurological follow-up evaluations.

As with other brain tumors, the risks of surgery may vary in direct proportion to the tumor size, while the chances of total resection vary inversely in proportion to the size of meningiomas of most locations. For example, it is quite obvious that removal of small parasag-gital tumors without any involvement of the sagittal sinus would be immensely easier compared to the removal of larger ones which commonly invade the sagittal sinus. The same may be said of small clinoidal or tuberculum sella meningiomas before causing optic nerve and ICA involvement, or petrous meningiomas prior to reaching a large size that would encase the basilar artery and compress the brainstem and cranial nerves. Therefore, the initial recommendation of observation must be decided upon carefully, especially in younger patients, taking into consideration the increased potential risks posed in the future by further growth in the tumor size and involvement of nearby critical neurovascular structures.

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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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