Meningioma: Types, Causes, Symptoms and Treatment

Overview

The human brain is protected by three layers of tissues known as meninges. When there is a tumor growing in any of the three layers is known as a meningioma. Meningioma is the most common form of brain tumor. It accounts for nearly 30% of all brain tumors. In this form of brain, the tumor grows gradually; it takes years before it shows any signs. Doctors may also accidentally find the tumor on an MRI scan when diagnosing other health conditions.

The blog explains meningiomas, their types, causes, symptoms, and various treatment options.

What is a Meningioma?

As mentioned earlier, meningioma is a tumor that develops in the protective tissues of the brain and the spinal cord, known as meninges. Technically it is not a brain tumor. Experts consider it a brain tumor as it may compress and apply pressure on the nearby tissues, nerves, and vessels. It grows gradually and inwards without causing any signs for years. But, in some instances, the effects of the tumor on the adjacent brain tissues, nerves, and vessels may lead to severe disability. 

It can occur at any age and is most noticed among women than men. Most meningiomas do not need immediate medical attention, and only monitoring the progress of the tumor over a period may be the need of the hour. The cancer is generally formed near the top and outer curves of the brain. Sometimes, they can form at the base of the skull as well. However, spinal meningiomas are rare.

A small percentage of meningiomas are cancerous and may spread rapidly. In such cases, they can spread to other parts of the brain and body parts, including the lungs. 

What are the Types of Meningioma?

The following are the different types of meningiomas:

1. Convexity meningioma: It develops at the brain’s surface, directly under the brain. It doesn’t show signs or symptoms until the tumor is large and is pushed onto the brain. This form of brain tumor accounts for nearly 20 percent of meningiomas. 
2. Falcine and parasagittal meningioma: These tumours grow between two sides of your brain, where there are numerious large blood vessels. Such kind of tumor may interfere with blood circulation in your brain, if it is sitting on surrounding blood vessels. 
3. Intraventricular meningioma is present within the ventricular system, where cerebrospinal fluid (CSF) is produced and distributed. This form of the tumor may block the CSF flow, resulting in hydrocephalus. 
4. Skull base meningioma: It grows near the bones that form the skull base and in the bony ridges at the back of the eye. These are more challenging to remove than convexity meningiomas surgically. 
5. Sphenoid wing meningioma: It grows on the skull base behind the eyes. Nearly 20% of meningiomas are sphenoid wing meningiomas. 
6. Olfactory groove meningioma: These tumours grow near the olfactory nerve, located between the brain and the nose. This form of tumor accounts for nearly 10 percent of all meningiomas. If you are diagnosed with meningioma, you may lose the sense of smell, and as the tumor grows, it may also cause vision issues. 
7. The posterior fossa meningioma is also called petrous meningioma: It is situated on the brain’s underside. It can put pressure on the cranial and trigeminal nerves, causing facial and hearing issues and a condition known as trigeminal neuralgia.
8. Suprasellar meningioma: It is found near the pituitary gland and optic nerve, causing visual issues and problems in the pituitary gland. 
9. Recurrent meningioma: As the name suggests, the tumor that occurs again is recurrent meningioma. When it happens again, it may be of the same grade or can be more aggressive than the last time.

What are the Symptoms of a Meningioma?

As the tumor grows gradually, the signs also develop slowly. Based on the location and size of the tumor, symptoms present. The most common symptoms of meningioma are as follows: 

1. Issues in the vision, such as seeing double or blurred vision
2. Extreme headaches, those that are worse in the morning
3. Hearing loss
4. Ringing in the ears
5. Loss of memory and smell
6. Seizure
7. Weakness in the arms and legs
8. Speech problems
9. Lightheadedness
10. Nausea and vomiting
11. Changes in behavior and personality
12. Overactive reflexes

When to Seek Medical Help?

Contact your doctor soon if you experience any meningioma symptoms.

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What Causes Meningioma?

The cause of meningioma is unknown. However, experts and doctors believe that certain cells are altered, making them rapidly multiply out of control resulting in the meningioma. Whether this occurs due to inherited genes, hormones, or prior radiation exposure is unknown. Some believe cell phones are to be blamed, but no scientific evidence exists. 

How do doctors diagnose a Meningioma?

Doctors find diagnosing a meningioma brain tumor challenging as it grows gradually. The symptoms may be subtle, and your doctor may confuse them with other medical conditions or typical signs of old age. If your neurologist suspects meningioma, they may prescribe the following tests:

• Imagining tests, including MRI and CT scans, indicate the tumor’s location and size.
• Sometimes, a biopsy may be required to remove a part or all of the tumor to check if the tumor is benign or malignant.

What are the Various Treatment Options Available for Meningioma?

Based on several factors, including the size and location of the tumor, the severity of your condition, your age and general health condition, and the goal of the treatment, your doctor may suggest the following treatment options: 

• Monitoring: If the tumor is small, slow growing, and is not showing signs, your doctor may decide to monitor its growth. They will monitor through periodic scans. However, if your healthcare provider notices growth, they may discuss the next course of treatment with you.
• Surgery: You may require surgery if there are signs of growth. Your neurologist may altogether remove the tumor. In some cases, where the tumor is growing near a delicate structure of the brain and the spinal cord, complete tumor removal may not be possible. Only follow-up scans for monitoring may be required if your surgeon has successfully removed the entire tumor. If a part of the tumor remains after surgery, the doctor may treat it with a form of radiation therapy known as stereotactic radiosurgery. 
• Radiation therapy: When surgery doesn’t remove the entire meningioma, your doctor may start radiation therapy as a follow-up treatment. The radiation kills the remaining cancerous cells and decreases the chances of reoccurrence. It uses high-powered energy beams to destroy cancerous cells. There are different forms of radiation therapy, such as:

1. Stereotactic radiosurgery: It is used when the tumors are not entirely removed during conventional surgery
2. Fractionated stereotactic radiotherapy: It is performed on people who cannot tolerate surgery or the cancer is large
3. Intensity-modulated radiation therapy: It uses computer software to change the intensity of the radiation and is performed on sensitive brain structures
4. Proton beam radiation: It accurately targets the tumor and reduces injuries to the nearby tissues. 
5. Chemotherapy: In rare cases, doctors may start you on chemotherapy when the tumor does not respond to surgery or radiation. It uses drugs to kill cancer cells. Bevacizumab is a form of chemotherapy that is typically prescribed for anaplastic meningiomas.

What are the Complications of Meningioma Brain Tumor?

Cancer and its treatments, particularly surgery and radiation therapy, may lead to long-term complications, such as:

• Problems concentrating
• Loss of memory
• Changes in personality and behavior
• Seizure
• Weakness
• Sensory abnormalities 
• Speech issues

Conclusion

Getting diagnosed with a brain tumor is unsettling. However, there is good news – meningiomas are treatable. Discuss with your healthcare team for customized and individualized treatment options that align with your treatment goal.

Frequently Asked Questions (FAQs)

Who is at risk of developing meningiomas?

Risk factors for a meningioma include:

1. Radiation therapy: Radiation treatment involving radiation to the head might raise the risk of meningioma.
2. An inherited nervous system disorder: Neurofibromatosis 2, a rare disorder, increases the risk of meningioma and other brain tumors.
3. Female hormones: Leading physicians believe that female hormones may play a role as meningiomas are more common in women. A few studies also suggest a link between meningioma risk and breast cancer. Some research suggests hormone replacement therapy and the use of oral birth control can increase the risk of meningioma growth.
4. Obesity: High BMI (body mass index) is a known risk factor for numerious types of cancers, and many large studies reveal a higher prevalence of meningiomas among obese people. However, the link between obesity and meningiomas is not clear.