From the Guidelines
A calcified meningioma of 1.1 cm in the left frontal area could potentially cause cold sensations or "brain freeze" feelings on the right side of the head, including the frontal and temporal areas, due to irritation of surrounding brain tissue or compression of nerves. This phenomenon occurs because of the brain's crossed wiring, where the left side of the brain controls the right side of the body, and vice versa. According to the NCCN clinical practice guidelines in oncology 1, the presentation and symptoms of central nervous system cancers, including meningiomas, depend largely on tumor location and patient age at the time of diagnosis. While the guidelines primarily discuss symptoms such as headaches, nausea, vomiting, and blurred vision, they also mention that other presenting symptoms can include seizure, hemiparesis, monoparesis, cranial nerve deficits, ataxia, hemisensory loss, dysphasia, aphasia, and memory impairment.
To get insurance approval for a brain MRI, it is essential to have your neurologist or primary care physician document your specific symptoms, the known meningioma, and how monitoring is medically necessary. They should submit a detailed prior authorization request emphasizing symptom progression and the need for evaluation of potential growth. The request should highlight the importance of monitoring the meningioma's size and potential impact on surrounding brain tissue.
For meningioma evaluation, an MRI both with and without contrast is typically needed, as contrast enhancement helps distinguish the tumor boundaries, assess vascularity, and determine if there's been any growth or changes since previous imaging. The contrast agent gadolinium allows better visualization of the meningioma's relationship to surrounding structures and helps differentiate between the tumor and potential edema or other abnormalities. This is crucial in assessing the tumor's impact on surrounding brain tissue and guiding potential treatment options. By prioritizing the use of MRI with and without contrast, healthcare providers can ensure that they have a comprehensive understanding of the meningioma's characteristics and potential effects on the patient's brain.
From the Research
Symptoms of Calcified Meningioma
- A calcified meningioma of 1.1 cm in the left frontal area can potentially cause symptoms due to its location and size, although the specific symptoms mentioned (cold sensation like brain freeze on the right frontal area radiating to the temporal area) are not directly addressed in the provided studies 2, 3, 4, 5, 6.
- Meningiomas can cause a variety of symptoms depending on their location, size, and effect on surrounding brain tissue, but the provided studies do not specifically discuss the symptoms mentioned in the question.
Insurance Approval for Brain MRI
- To get insurance to approve a brain MRI, it is typically necessary to provide medical justification for the procedure, which may include symptoms or other indications of a potential brain abnormality 3, 4, 5.
- The specific requirements for insurance approval may vary depending on the insurance provider and the individual's policy.
MRI with and without Contrast
- The use of contrast agents in MRI scans of meningiomas is a topic of ongoing research, with some studies suggesting that lower doses of contrast may be sufficient for diagnostic purposes 2.
- The study by 2 found that reducing the gadolinium dose to 62% of the standard level still allowed for sufficient visual delineation of meningiomas from surrounding tissues, but further reduction to 25% substantially compromised the ability to distinguish the tumor from adjacent structures.
- Whether an MRI with and without contrast is needed may depend on the specific clinical question being addressed and the preferences of the radiologist or treating physician 3, 4, 5.