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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), ...
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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. This may lead to symptoms such as vision problems, seizures, weakness, or language problems. These tumors may be grade I, II, or III. Type III is the most aggressive type.
Malignant meningiomas (also called anaplastic or grade III) are less common. These tumors are faster growing. They often cause problems and can cause some swelling in the brain.
Some meningiomas may require some form of therapy, surgery, and/or radiotherapy. The treatment will depend on the location of the tumor.
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—may increase the growth of meningiomas.
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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
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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
- Cognitive difficulty
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Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will have a neurologic examination. Other tests may include:
- CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body, in this case the head
- MRI scan —a test that uses magnetic waves to make pictures of the inside of the body, in this case the head
- Angiogram —the injection of a special dye to highlight blood vessels in the brain
- Electroencephalogram (EEG) —a test that records the brain's activity by measuring electrical currents through the brain
MRI of Meningioma in the Brain
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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.
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Prevention
There are no guidelines for the prevention of meningiomas.
