Delay in diagnosis is common, secondary to the occult nature of the disease and poorly localizing signs and symptoms. A headache arising in the vertex, ipsi-parietal, orbital, or frontal regions is a typical early symptom. This is due to stretching of middle fossa dura and is often severe. Recurrent meningitis has also been noted in these patients. The late symptoms generally depend on the direction of tumor extension.
Anterior extension leads to diplopia and ophthalmoplegia, or both.
Posterior extension presents as facial or other lower cranial nerve neuropathies. However, they are also seen with chondrosarcomas and other similar lesions. Foci of calcification may also be seen. The CT scan is useful in defining the anatomy of bone destruction. MRI is better than CT for defining the limits of a lesion and any vascular relationships, especially on the T2-weighted images.