Dural tail sign

Changed by Bruno Di Muzio, 2 Jul 2015

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The dural tail sign occurs as a result of thickening and enhancement of the dura and is most often seen adjacent to a meningioma. Initially the sign was felt to be pathognomonic of meningiomas, however as experience grew, it has become increasingly noted to be present in many other conditions, although without the same regularity.

Pathology

Initially the dural tail was thought to result from direct invasion of the dura by the tumour however subsequent studies demonstrated it to be predominantly a reactive process due to vascular congestion and oedema. Having said that, the literature is still divided and a wide range of prevalence of tumour invasion of the dural tail has been reported (0-100%), with generally higher prevalences in WHO II (atypical) meningiomas 4,5. This is further complicated by the presence of tumour cells in apparently normal dura adjacent to tumours 5.  

Treatment and prognosis

Whether or not the dural tail should be resected and if so how much surrounding dura should be included in the resection (or gamma knife field) continues to be debated 4,5,7

History and etymology

It was first described in 1989 by Wilms et al. as thickening of the dura surrounding meningiomas 5.

  • -<p>The <strong>dural tail sign</strong> occurs as a result of thickening and enhancement of the <a href="/articles/dura-mater">dura</a> and is most often seen adjacent to a <a href="/articles/meningioma">meningioma</a>. Initially the sign was felt to be pathognomonic of meningiomas, however  as experience grew, it has become increasingly noted to be present in many other conditions, although without the same regularity.</p><ul>
  • +<p>The <strong>dural tail sign</strong> occurs as a result of thickening and enhancement of the <a href="/articles/dura-mater">dura</a> and is most often seen adjacent to a <a href="/articles/meningioma">meningioma</a>. Initially the sign was felt to be pathognomonic of meningiomas, however as experience grew, it has become increasingly noted to be present in many other conditions, although without the same regularity.</p><ul>
  • -<li><a href="/articles/glioblastoma">glioblastoma</a></li>
  • +<li>
  • +<a href="/articles/glioblastoma">glioblastoma</a> (case 5)</li>
  • -</ul><h4>Pathology</h4><p>Initially the dural tail was thought to result from direct invasion of the dura by the tumour however subsequent studies demonstrated it to be predominantly a reactive process due to vascular congestion and oedema. Having said that, the literature is still divided and a wide range of prevalence of tumour invasion of the dural tail has been reported (0-100%), with generally higher prevalences in WHO II (atypical) meningiomas <sup>4,5</sup>. This is further complicated by the presence of tumour cells in apparently normal dura adjacent to tumours <sup>5</sup>.  </p><h4>Treatment and prognosis</h4><p>Whether or not the dural tail should be resected and if so how much surrounding dura should be included in the resection (or gamma knife field) continues to be debated <sup>4,5,7</sup>. </p><h4>History and etymology</h4><p>It was first described in 1989 by <strong>Wilms</strong> et al as thickening of the dura surrounding meningiomas <sup>5</sup>.</p>
  • +</ul><h4>Pathology</h4><p>Initially the dural tail was thought to result from direct invasion of the dura by the tumour however subsequent studies demonstrated it to be predominantly a reactive process due to vascular congestion and oedema. Having said that, the literature is still divided and a wide range of prevalence of tumour invasion of the dural tail has been reported (0-100%), with generally higher prevalences in WHO II (atypical) meningiomas <sup>4,5</sup>. This is further complicated by the presence of tumour cells in apparently normal dura adjacent to tumours <sup>5</sup>.  </p><h4>Treatment and prognosis</h4><p>Whether or not the dural tail should be resected and if so how much surrounding dura should be included in the resection (or gamma knife field) continues to be debated <sup>4,5,7</sup>. </p><h4>History and etymology</h4><p>It was first described in 1989 by <strong>Wilms</strong> et al. as thickening of the dura surrounding meningiomas <sup>5</sup>.</p>
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