Meningiomas are usually slow-growing tumors that develop from the meninges, the protective layer of the brain and spinal cord. Meningomas account for about 20 percent of primary brain tumors and are most likely found in middle-aged or elderly adults, more commonly in women than men. Although they are almost always benign, meningiomas can be difficult to remove completely and can recur.
Diagnosing a brain tumor usually involves several steps. The physician may perform a neurological exam, computerized tomography (CT), magnetic resonance imaging (MRI) scan, angiogram and head and skull x-rays.
A meningioma can cause a diversity of symptoms because it can directly press on brain tissue, damaging or destroying areas responsible for sight, movement, balance, speech, hearing, memory or behavior.
Brain tumor symptoms initially may be vague and come-and-go, delaying diagnosis. Other diseases can cause similar symptoms.
Symptoms can include:
Headaches
Problems with memory, concentration and/or forming words
Personality changes
Vision problems (blurred or double vision, loss of peripheral vision)
Gradual loss of sensation or movement in an arm or leg
Loss of balance or hearing
Difficulty swallowing
Drowsiness
Seizures
Decreased sense of smell
Initial Treatment Steps
Steroid medications may be needed to reduce swelling and inflammation of brain tissue.
Anticonvulsant medications may be prescribed to help control seizures.
A shunt may be inserted if the tumor has resulted in a buildup of fluid in the brain (hydrocephalus). The tube allows excess fluid from the brain to drain into the abdominal cavity where it is reabsorbed.
TREATMENT
Surgery is usually the first approach. Because meningiomas tend to have well-defined edges and do not invade the brain, complete removal is sometimes possible. The standard treatment is to remove the tumor, the portion of the lining of the brain or spinal cord to which it is attached and any bone involved.
Many of these tumors are at the base of the brain and are located near cranial nerves and blood vessels and surgery is more complicated because of the risk of damaging the nerves and blood vessels. Complete surgical removal is sometimes not possible.
Even with removal, meningiomas are not always cured, the recurrence rate varies from 10 to 20 percent (measured over 10 years). When the entire tumor is not removed, the recurrence rate is higher.
Computer-Assisted Surgery for Tumor Removal
Computer-assisted tumor removal (volumetric stereotactic resection) is a surgical method that uses computer-generated models of the tumor built from data obtained by computer imaging techniques. This allows the neurosurgeon to simulate the surgical procedure beforehand to reach a brain tumor using the least invasive route possible.
Radiation
Radiation uses high-energy X-rays to destroy meningioma cells and often is used to destroy any remaining tumor cells that could not be removed surgically.
Stereotactic Radiosurgery
The treatment precisely focuses radiation beams to the tumor. (Gamma Knife™ surgery )
This treatment shows a decreased incidence of cranial nerve damage following radiosurgery and an improved chance that the tumors will not recur.
The advantage of stereotactic radiosurgery is that surrounding, healthy tissue receives minimal radiation compared to the tumor.
Fractionated Stereotactic Radiosurgery (FSR)
FSR provides multiple smaller treatments to spare the normal tissues but destroy the meningioma.
For this procedure, the patient is fitted with a plastic mask that aids in positioning and locating the tumor during treatment. The treatment is given in several smaller units called "arcs." The number of treatments depends on the size and location of the meningioma.
External-Beam Radiation
This traditional form of radiation therapy delivers radiation from outside the body. The radiation usually involves treatments five days a week for a length of time determined by the type of tumor. External beam radiation is less precise, but allows a wider margin of tissue around the tumor to be treated.
Chemotherapy and Other Drug Therapy
Combination Treatments are also used.
Diagnosing a brain tumor usually involves several steps. The physician may perform a neurological exam, computerized tomography (CT), magnetic resonance imaging (MRI) scan, angiogram and head and skull x-rays.
A meningioma can cause a diversity of symptoms because it can directly press on brain tissue, damaging or destroying areas responsible for sight, movement, balance, speech, hearing, memory or behavior.
Brain tumor symptoms initially may be vague and come-and-go, delaying diagnosis. Other diseases can cause similar symptoms.
Symptoms can include:
Headaches
Problems with memory, concentration and/or forming words
Personality changes
Vision problems (blurred or double vision, loss of peripheral vision)
Gradual loss of sensation or movement in an arm or leg
Loss of balance or hearing
Difficulty swallowing
Drowsiness
Seizures
Decreased sense of smell
Initial Treatment Steps
Steroid medications may be needed to reduce swelling and inflammation of brain tissue.
Anticonvulsant medications may be prescribed to help control seizures.
A shunt may be inserted if the tumor has resulted in a buildup of fluid in the brain (hydrocephalus). The tube allows excess fluid from the brain to drain into the abdominal cavity where it is reabsorbed.
TREATMENT
Surgery is usually the first approach. Because meningiomas tend to have well-defined edges and do not invade the brain, complete removal is sometimes possible. The standard treatment is to remove the tumor, the portion of the lining of the brain or spinal cord to which it is attached and any bone involved.
Many of these tumors are at the base of the brain and are located near cranial nerves and blood vessels and surgery is more complicated because of the risk of damaging the nerves and blood vessels. Complete surgical removal is sometimes not possible.
Even with removal, meningiomas are not always cured, the recurrence rate varies from 10 to 20 percent (measured over 10 years). When the entire tumor is not removed, the recurrence rate is higher.
Computer-Assisted Surgery for Tumor Removal
Computer-assisted tumor removal (volumetric stereotactic resection) is a surgical method that uses computer-generated models of the tumor built from data obtained by computer imaging techniques. This allows the neurosurgeon to simulate the surgical procedure beforehand to reach a brain tumor using the least invasive route possible.
Radiation
Radiation uses high-energy X-rays to destroy meningioma cells and often is used to destroy any remaining tumor cells that could not be removed surgically.
Stereotactic Radiosurgery
The treatment precisely focuses radiation beams to the tumor. (Gamma Knife™ surgery )
This treatment shows a decreased incidence of cranial nerve damage following radiosurgery and an improved chance that the tumors will not recur.
The advantage of stereotactic radiosurgery is that surrounding, healthy tissue receives minimal radiation compared to the tumor.
Fractionated Stereotactic Radiosurgery (FSR)
FSR provides multiple smaller treatments to spare the normal tissues but destroy the meningioma.
For this procedure, the patient is fitted with a plastic mask that aids in positioning and locating the tumor during treatment. The treatment is given in several smaller units called "arcs." The number of treatments depends on the size and location of the meningioma.
External-Beam Radiation
This traditional form of radiation therapy delivers radiation from outside the body. The radiation usually involves treatments five days a week for a length of time determined by the type of tumor. External beam radiation is less precise, but allows a wider margin of tissue around the tumor to be treated.
Chemotherapy and Other Drug Therapy
Combination Treatments are also used.
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