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Meningioma

Overview

The brain and spinal cord are protected by three layers of tissue called meninges. The innermost layer, the pia mater, is very thin. The middle layer, the arachnoid, is like a delicate web filled with fluid that acts as a shock absorber for the brain. The outermost layer, the dura mater, is tough and protective.

Most meningiomas, which are tumors that grow in the meninges, develop slowly. They might grow for years without causing any noticeable problems. However, as they grow larger, they can put pressure on nearby brain tissue, nerves, or blood vessels. This pressure can lead to serious problems and disabilities.

Meningiomas are more common in women than men, and they are typically found in older adults. But they can affect people of any age.

Since many meningiomas grow slowly and don't initially cause symptoms, treatment isn't always needed immediately. Instead, doctors may simply monitor the tumor's growth over time, intervening only if it becomes problematic.

Symptoms

Meningiomas are tumors that grow in the membranes surrounding the brain and spinal cord. Most often, these tumors develop gradually, meaning the symptoms appear slowly and might be hard to notice initially. The specific symptoms depend on exactly where in the brain or (less commonly) the spine the tumor is located.

Possible symptoms include:

  • Vision problems: Double vision or blurry vision.
  • Headaches: Headaches that are typically worse in the morning.
  • Hearing issues: Loss of hearing or ringing in the ears (tinnitus).
  • Memory problems: Difficulty remembering things.
  • Loss of smell: Inability to smell certain things.
  • Seizures: Sudden bursts of electrical activity in the brain, often causing involuntary movements or changes in awareness.
  • Weakness: Trouble using your arms or legs.
  • Speech difficulties: Problems speaking clearly.

Importantly, most symptoms of a meningioma develop slowly. This means you might not notice them right away. However, some situations require immediate medical attention. Seek emergency care if you experience:

  • Sudden seizures: If seizures start suddenly.
  • Sudden changes in vision or memory: If your vision or memory changes abruptly.

If you have any persistent symptoms that worry you, such as headaches that gradually worsen over time, schedule an appointment with your doctor. Often, meningiomas are discovered incidentally during medical imaging tests done for other reasons, as they might not always cause noticeable symptoms.

When to see a doctor

Meningiomas, a type of brain tumor, often develop slowly. However, some cases require immediate medical attention.

Go to the emergency room right away if you experience:

  • Sudden seizures: This means unexpected, uncontrolled episodes of shaking or jerking.
  • Sudden changes in vision or memory: Noticeable and sudden problems seeing or remembering things. This could include blurry vision, double vision, trouble recognizing faces, or forgetting recent events.

Schedule a doctor's appointment if you have any persistent symptoms that concern you, especially if they worsen over time. A common example is a headache that gradually gets worse.

Many meningiomas don't cause any noticeable symptoms. This means they might only be detected during medical imaging tests done for other reasons, like a routine checkup or a scan for something else entirely.

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Causes

Meningiomas are tumors that grow from the meninges, the protective membranes surrounding the brain and spinal cord. Scientists don't fully understand what triggers these tumors. Essentially, something causes certain cells in the meninges to start growing and dividing uncontrollably, forming a meningioma.

One environmental factor that's linked to meningiomas is childhood exposure to radiation. This is the only environmental risk factor currently recognized by experts. There's no strong scientific evidence to suggest that using cell phones causes meningiomas.

Risk factors

Meningiomas are brain tumors that can sometimes develop due to several factors. Understanding these factors can help people make informed choices and talk to their doctors about any concerns.

Here are some things that might increase the chance of getting a meningioma:

  • Radiation to the head: If you've had radiation therapy focused on your head, you may have a slightly higher risk of developing a meningioma. This is because radiation can sometimes damage cells and lead to abnormal growth.

  • Being a woman: Meningiomas are more common in women than men. Scientists aren't entirely sure why, but it's thought that female hormones might be involved. Some studies have explored possible connections between hormones, breast cancer, and meningiomas. Specifically, some research suggests that using oral contraceptives (birth control pills) or hormone replacement therapy might slightly increase the risk of a meningioma developing or growing larger. More research is needed to fully understand this relationship.

  • A family history of certain nervous system conditions: A rare genetic disorder called neurofibromatosis type 2 (NF2) significantly raises the risk of meningiomas and other brain tumors. This is because NF2 affects the body's ability to control cell growth.

  • Obesity: A higher body mass index (BMI), a measure of body fat, is a risk factor for many different types of cancer, including meningiomas. Several large studies have shown a link between obesity and an increased likelihood of developing meningiomas. However, the exact reason why obesity might increase meningioma risk isn't fully understood. More research is needed to determine the specific connection.

It's important to remember that these factors don't guarantee you'll get a meningioma. They simply increase your chances. If you have concerns about your risk, it's essential to talk to your doctor.

Complications

Meningiomas are tumors that grow in the membranes surrounding the brain. Treatment usually involves surgery to remove the tumor and radiation therapy to kill any remaining cancer cells. While surgery is often effective, it can lead to some long-lasting side effects.

These side effects can include difficulties concentrating and remembering things. People might also experience changes in their personality, have seizures, feel weak, or notice changes in their senses (like sight or hearing). Problems with language are also possible.

It's important to talk to your doctor about these potential problems. Your doctor can help manage some of these complications. They may also recommend specialists, like therapists or neurologists, to help you deal with the long-term effects of the treatment.

Diagnosis

A brain scan, specifically a contrast-enhanced MRI, revealed a meningioma. This tumor had grown large enough to press on the brain.

Meningiomas are often tricky to detect because they grow slowly. The early symptoms are sometimes mild or are mistaken for other health problems, or even just part of getting older.

If a doctor suspects a meningioma, you might be referred to a neurologist, a specialist in brain and spine conditions.

To confirm the diagnosis, a neurologist will first do a thorough check of your reflexes and other neurological functions. Then, they'll likely order imaging tests, such as:

  • CT scan: This scan uses X-rays to create detailed cross-sectional images of the brain. Sometimes, a special dye (often containing iodine) is used to highlight the tumor and make it easier to see on the scan.
  • MRI scan: This scan uses a powerful magnet and radio waves to create detailed cross-sectional images of the brain. MRI scans are usually better at showing the details of meningiomas compared to CT scans.

Sometimes, a small piece of the tumor (a biopsy) is taken and examined in a lab. This helps to make sure it's a meningioma and rule out other types of brain tumors.

Treatment

Meningioma Treatment Options and Considerations

A meningioma is a type of brain tumor that grows from the membranes surrounding the brain and spinal cord. Treatment decisions depend on several factors:

  • Tumor characteristics: How large is the tumor? Where is it located? How quickly is it growing?
  • Your health: Your age, overall health, and other medical conditions are important.
  • Your goals: What are your priorities for treatment? Do you want to aggressively remove the tumor, or is the primary goal to manage it and prevent symptoms?

Not everyone needs immediate treatment. A small, slow-growing meningioma that isn't causing problems might not require any treatment at all. Instead, doctors will likely monitor it with regular brain scans to check for growth.

If treatment is needed, there are several options:

Surgery: If a meningioma is causing symptoms or is growing rapidly, surgery is often considered. Surgeons aim to remove the entire tumor, but sometimes this isn't possible due to the tumor's location near delicate brain structures. In these cases, surgeons will remove as much of the tumor as safely possible.

Post-Surgery Considerations: What happens after surgery depends on the amount of tumor remaining:

  • No visible tumor: No further treatment is usually needed, but regular follow-up scans are essential.
  • Small amount of tumor remains: Follow-up scans and possibly a type of radiation therapy called stereotactic radiosurgery might be recommended for small, benign remnants.
  • Irregular or cancerous tumor: Radiation therapy is likely necessary to target any remaining tumor cells.

Risks of Surgery: Surgery carries risks, including infection and bleeding. The specific risks depend on the meningioma's location. For example, removing a meningioma near the optic nerve could potentially affect vision. Always discuss the risks with your surgeon.

Radiation Therapy: If surgery isn't possible to remove the entire tumor, or if the tumor is large or complex, radiation therapy may be a treatment choice, either after or instead of surgery. The goal is to destroy remaining tumor cells and reduce the chance of recurrence. Modern radiation techniques target the tumor more precisely, minimizing damage to healthy tissue.

  • Stereotactic Radiosurgery (SRS): High-powered radiation beams are precisely targeted to the tumor in a single session, often as an outpatient procedure.
  • Fractionated Stereotactic Radiotherapy (SRT): Lower doses of radiation are delivered over several days.
  • Intensity-Modulated Radiation Therapy (IMRT): Computer software adjusts the radiation dose to precisely target the tumor while sparing surrounding healthy tissue.
  • Proton Beam Radiation: Proton beams are directed at the tumor, potentially reducing damage to nearby healthy tissue.

Medications: Chemotherapy is rarely used for meningiomas, but it might be considered in cases where the tumor doesn't respond to surgery or radiation. Research into targeted therapies is ongoing.

Alternative Therapies: Alternative medicine treatments like acupuncture, hypnosis, massage, meditation, and music therapy might provide relief from treatment side effects or help cope with the emotional stress of the diagnosis. However, these therapies are not a substitute for conventional medical treatment.

Living with a Meningioma Diagnosis:

Dealing with a meningioma diagnosis can be challenging. To help manage the experience:

  • Information Gathering: Learn as much as you can about meningiomas and your treatment options. Talk to your healthcare team, use online resources, and visit your local library. Write down questions for your doctor.
  • Self-Care: Prioritize physical and mental well-being. Maintain a healthy diet, get regular exercise (if appropriate), and ensure sufficient sleep. Manage stress effectively.
  • Support Systems: Connect with others facing similar challenges. Consider joining support groups, either in person or online. The American Brain Tumor Association is a valuable resource.

Remember to always discuss your treatment options and any concerns with your healthcare team. They are the best resource for personalized advice.

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Disclaimer: August is a health information platform and its responses don't constitute medical advise. Always consult with a licenced medical professional near you before making any changes.

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