Meningioma

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 graded I-III, with III being the most aggressive.Malignant meningiomas, also called anaplastic, are less common. These tumors are faster growing and very likely to return.
Meningioma
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Causes

The exact cause of meningiomas is unknown. The development appears to be associated with genetics and certain hormones.

Risk Factors

Meningiomas are more common in women, and in those aged 40-70 years. Other factors that may increase your chance of meningioma include:
  • History of breast cancer or sarcoma, as part of the Li-Fraumeni syndrome
  • Neurofibromatosis type 2 (NF2)
  • Exposure to radiation, 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
  • Double vision
  • Slurred speech
  • Changes in behavior
  • Seizures
  • Loss of sensation or weakness in the arms and legs
  • Loss of bladder or bowel control
  • Language deficits
  • Difficulty with learned movements
  • Loss of coordination
  • Difficulty writing
  • Intellectual difficulty

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You will have a neurological examination.The brain can be evaluated with imaging tests. These may include: Your brain activity may need to be measured. This can be done with an electroencephalogram (EEG).
MRI of Meningioma in the Brain
Meningioma MRI
Copyright © Nucleus Medical Media, Inc.

Treatment

Treatment will depend on the size and location of the tumor, its rate of growth, and your general health. The main types of treatment for meningiomas are:

Surgery

Surgery may be recommended if the tumor is located in an area that is easily reached. Most surgeries can be done without causing neurological damage.

Embolization

Tumors need blood flow to survive. In some instances, prior to surgery, a catheter may be inserted into blood vessels supplying the tumor. It will disrupt the flow of blood to the tumor. This will make the tumor shrink. The smaller tumor can then be removed with surgery.

Radiation Therapy

Radiation therapy is used either on its own or after surgery has been done. Some tumors may be located in an area that is difficult or too dangerous to operate on. Radiation may be used on its own if the tumor is causing symptoms and cannot be removed with surgery. Radiation therapy is an effective way of treating the tumor and stopping its growth.If the tumor is a higher grade, radiation is generally considered. 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 fewer treatments if you are having stereotactic radiosurgery. This type of surgery delivers higher doses of radiation during each treatment.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It is used when other treatment methods fail.

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Prevention

There are no current guidelines to prevent meningiomas.

RESOURCES

National Brain Tumor Society
http://braintumor.org

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES

Brain Canada
http://www.braincanada.ca

Brain Tumor Foundation of Canada
http://www.braintumour.ca

References

Keller A, Ludwig N, Comtesse N, et al. H-P A minimally invasive multiple marker approach allows highly efficient detection of meningioma tumors. BMC Bioinformatics. 2006,7:539.

Meningioma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 2, 2013. Accessed February 13, 2014.

Meningioma. International Radiosurgery Association website. Available at: http://www.irsa.org/meningioma.html. Accessed February 13, 2013.

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