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Meningioma

A meningioma is a tumor of the protective lining of the brain and spinal cord. This lining is called the meninges. Most meningiomas are benign (noncancerous), ...

condition

Definition

The meninges are a protective lining around the brain and spinal cord. A meningioma is a tumor of these linings. Most meningiomas do not cause symptoms. But, if the meningioma grows, it can push on important parts of the brain. These tumors may be grade I, II, or III.

Grade III is the most aggressive type. Malignant meningiomas, also called anaplastic, are less common. These tumors are faster growing. They often cause problems and some can cause some swelling in the brain.

Meningioma

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Causes

The exact cause of meningiomas is unknown. Factors that may be associated with these tumors include:

  • Genetic predisposition
  • Certain hormones

Risk

Factors that may increase the risk of meningioma include:

  • Sex: twice as common in women than men
  • Age: 40-70
  • History of breast cancer or sarcoma, as part of the Li-Fraumeni syndrome
  • A diagnosis of neurofibromatosis type 2 (NF2)
  • Radiation exposure, especially to the head

Symptoms

Symptoms of meningioma are usually related to the area of the brain that is affected. Symptoms can also be due to an increase in the pressure inside the skull. Symptoms may include:

  • Headaches
  • Vomiting
  • Visual problems
  • Changes in behavior
  • Seizures
  • Pain
  • Loss of sensation or weakness in the arms and legs
  • Loss of bladder or bowel control
  • Slurred speech
  • Language deficits
  • Difficulty with learned movements
  • Loss of coordination
  • Difficulty writing
  • Intellectual difficulty
diagnosis

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will have a neurologic examination.

Images of your head may need to be viewed. This can be done with:

  • CT scan
  • MRI scan
  • Angiogram

Your brain activity may need to be measured. This can be done with an electroencephalogram (EEG).

MRI of Meningioma in the Brain

Meningioma MRI
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treatment

Treatment

Treatment will depend on whether the tumor is malignant or benign, the size and position of the tumor, as well as your general health. The main types of treatment for meningiomas are:

Surgery

Surgery may be recommended if the tumor is located in an area of the brain that is accessible to surgery. Most surgeries can be performed without causing neurologic damage.

Embolization

In some instances, prior to surgery, a catheter may be inserted into blood vessels supplying the meningioma in order to disrupt the flow of blood to the tumor, causing it to shrink and making it easier to remove surgically.

Radiation Therapy

Radiation therapy is used either on its own or after surgery has been performed. If the tumor is not located in an area of the brain where surgery can be safely done, and the tumor is causing problems, radiation therapy is an effective way of treating the tumor and stopping its growth. If the tumor is malignant, radiation is generally always offered. In this case, radiation may be given either on its own or after surgery to help prevent the tumor from coming back.

Your radiation oncologist will describe how the therapy is delivered and how many treatments are needed. You may receive 25-40 treatments on a daily basis, or far fewer treatments if you are having stereotactic radiotherapy (surgery).

Chemotherapy

Chemotherapy is used only in the treatment of malignant meningiomas. Different medications are available and are generally used in conjunction with surgery and radiation therapy. Your oncologist will discuss the options and choice of medications.

Gamma Knife Radiosurgery

Gamma Knife delivers radiation more accurately and precisely than conventional radiation therapy. It's often recommended for tumors that are in difficult-to-reach places in the brain.

prevention

Prevention

There are no guidelines for the prevention of meningiomas.

Advanced Treatment

Treatment of tumors at the base of the skull is highly complex. These tumors are hard to reach, and surgery is a delicate process that can affect many areas of the body.

At UVA’s Skull Base Center, we have a team of experts who provide comprehensive management of these challenging tumors.

Treatment approaches include Gamma Knife Radiosurgery, for faster planning and treatment of complex tumors without invasive surgery

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