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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 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

Causes

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

Genetic predisposition
Certain hormones

Risk Factors

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:

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

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:

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

MRI of Meningioma in the Brain

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

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 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 is used only after other treatment methods have failed. Your oncologist will discuss the options and choice of medications.

Prevention

There are no guidelines for the prevention of meningiomas.

National Brain Tumor Society

http://braintumor.org

National Cancer Institute

http://www.cancer.gov

Brain Canada

http://www.braincanada.ca

Brain Tumor Foundation of Canada

http://www.braintumour.ca

Greenberg HS. Meningiomas. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. Available at: http://www.medlink.com. Accessed March 17, 2007.

Meningioma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 13, 2013. Accessed May 20, 2013.

Meningioma. International Radiosurgery Association website. Available at: http://www.irsa.org/meningioma.html. Accessed May 20, 2013.

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

Last reviewed May 2013 by Rimas Lukas, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.