What is Meningioma? Symptoms, Diagnosis and Treatments

Table of Contents

Meningioma is a tumor that originates in the central nervous system.

Meningioma tumors generally form on the tissues or membranes that cover the spinal cord and brain just outside of the skull.

Meningiomas formulate on the surface of the spinal cord or brain.

Meningiomas also occur in the membranes that surround the brain and spinal cord.

There are three layers of membranes that are described as meninges.

The tumors do not invade what is deemed as normal brain tissue, and severe symptoms may be caused if the adjacent parts of the brain have any form of pressure placed upon them by the compression of the tumor.

The tumor pushes the brain away rather than grow from within it.

The tumors are slow-growing and are generally benign.

On average, most tumors occur within the brain, but there are documented cases where tumors have been found on the spinal cord.

All benign tumors are generally removed to prevent, restore, or maintain a healthy neurological function.

Over 90 percent of these tumors are benign or noncancerous.

The rare tumors are anaplastic.

Meningioma accounts for about 30 percent of all brain tumors and is the most common type of primary brain tumor.

Breaking that percentage down further with 10 percent being tumors of the spine, and 20 percent are tumors that have originated from the head.

Often the benign tumor will exhibit no symptoms and will not require treatment.

But there can be serious issues with the growth of a benign tumor and can be fatal.

A very small number of tumors are cancerous and are generally atypical.

Atypical is benign or malignant.

Benign is noncancerous and malignant is cancerous.

Atypical tumors will exhibit cancer-like symptoms.

Benign tumors are slow-growing.

Malignant tumors tend to grow quickly and can spread to other parts of the brain as well as other parts of the body.

Meningioma and occurs more often in middle-aged women than in men.

Female hormones play a major factor in the risk level.

There are over 200,000 cases documented each year with the age of women ranging from 30 to 60.

Again doctors believe this number is due to the female hormones and females with an inherited hormonal condition.

Patients with neurofibromatosis 2 are placed at a higher risk of being diagnosed with a form of meningioma tumor.

However males are not immune to being diagnosed, this is because males do carry a form of female hormone in the system.

These tumors grow inside your skull and that is always a major cause for concern because they can cause water on the brain.

Major swelling of the brain can also happen.

All of this will affect memory, gait, and vision.

Meningioma can also grow in other areas of your brain and may affect your senses, hearing, or even the mere functionality of the pituitary gland.

Many have disputed the correct terminology of meningioma.

Some state that it is indeed a tumor while others state that technically they are not brain tumors at all.

Meningioma arises from cells within the meninges or layers thus they are technically not tumors.

This statement was made because meningioma does not result from mutated brain cells whereas a true tumor does.

It has and still is a reoccurring argument amongst the medical professions and their field of expertise.

 

History

In 1869-1922 Harvey Cushing used the terminology Meningioma to describe a series of tumors that occurred throughout the brain and spinal cord or the neuraxis but had various commonalities amongst themselves.

Charles Oberlong separated those commonalities into understandable subtypes.

The subtypes were solely based on the structure of the involved cells.

Over the years, several other researchers took part in redefining dozens of subtypes as well.

The earliest documented evidence of a probable meningioma was found in Germany.

A skull was found that was approximated to be at least 365,000 years old.

Numerous other examples have been found in South America, Africa, and North America.

In the 1600’s Felix Plater (1536-1614) performed an autopsy on Sir Caspar Bonecurtis.

His autopsy is the earliest written record although the results of the findings are questionable.

In the sixteenth century, the first attempted and documented surgery to remove a meningioma tumor occurred.

The first successful surgery was actually performed by Antoine Luis in 1770.

Zanobi Pecchioli who was a professor at the University of Siena performed an extremely successful removal of a skull base in 1835.

His surgery and the results of the surgery were then documented.

Leonard Wood was one of the first patients to undergo surgery in 1910, thus making a major advance in neurosurgery.

The listed types of meningioma are as follows: Convexity, Sphenoid Wing, Supraseller, Parasagittal and Facine, Intraventricular, Olfactory Groove, Optic Nerve Sheath, Posterior Fossa/Petrous, Spinal, and Foramen Magnum.

Each one affects a different part of the body or a combination of areas.

One or more areas may dictate a different type of meningioma.

In 2011 Mary Tyler Moore underwent surgery to remove a benign tumor.

It was a fairly routine and elective procedure.

Marys’ neurologist recommended that she have it removed while she was healthy.

Sheryl Crow was diagnosed in 2012 and is living happy and healthy with her tumor.

No plans for surgery unless it becomes absolutely necessary.

Kyle Kuric began to have headaches and tests revealed meningioma.

He had surgery in Barcelona to remove his tumors only to be readmitted into the hospital for post-operative swelling of the brain.

A second surgery was performed to relieve the pressure.

Kathi Goertzen made her diagnosis public and her viewers followed her battle.

She had reoccurring tumors and in 2012 she lost her battle due to complications that were related to her treatment.

Kathi was a well-known news anchor and future spokesperson regarding this ailment.

Her intention for going public with her diagnosis was solely to make meningioma known to the public.

Her fight was a major focal point for the issue.

In 2014, Eileen Ford, president, and creator of the Ford Modeling Agency passed away from complications of meningioma.

 

Risk Factors

Keep in mind that if you have one or more of the following risk factors does not necessarily mean that you have or will have meningioma.

It is highly recommended that you do seek out medical advice with your primary care physician to assist in a complete and accurate diagnosis.

Never self-diagnose yourself strictly from what you may read on the internet.

Always seek medical treatment for the current tests to verify.

  • Prior head injury. This depends on the severity and the location of the injury.
  •  Female hormones.
  •  Inherited central nervous system disorder is known as Neurofibromatosis type 2.
  • Having been employed in or worked out in the electric fields with transformers or previously worked in magnetic fields. Chemicals and sound waves released may contribute to the chances of a meningioma tumor forming.
  • Worked in the rubber industry or the hot plastic mold processing plants because of a particular chemical used in the melting and heating process. Vinyl chloride has been widely used in the manufacturing process of plastics.
  •  Exposure to certain dust from metal and their fumes caused by extreme welding and fabricating.
  •  Breast cancer survivor.
  •  Previous use of hormone replacement therapy.
  •  Smoking.
  •  Having or have had epilepsy.
  •  Being over-exposed to dental x-rays. For instance, getting too many dental x-rays in a short period of time.

Long time usage of cell phones has always been a huge concern.

There is no documented proof that this statement is true.

It may be several years before any formal concrete determination that the overuse of cell phones causes cancer or brain tumors.

Researchers and physicians do advise to utilize an earpiece to reduce or eliminate any chances.

Family history does not necessarily determine the risk.

Nor does age, sex, race, creed, or culture of the patient.

 

Screening

There is no formal screening that can be performed.

Comprehensive tests and exams are performed to determine whether or not a tumor is present with a diagnosis being the end result.

More information about these topics will be described below in greater detail.

Let it be noted that in January of 2004 legislation was put into place to document all future diagnosed tumors.

The Benign Brain Tumor Cancer Registries Amendment now requires all cancer registries to collect incidence information on all benign brain tumors.

The registries must also collect data on any and all of the diagnosed malignant tumors.

The Surveillance, Epidemiology, and Ends Results program of the National Cancer Institute has voluntarily agreed to assist in collecting all of the required data.

The information will aid in providing valuable resources for calculating and estimating the survival rate as well as the overall occurrences in incidences.

The data also helps in creating a mechanism that will identify persons for epidemiologic and various other types of research studies.

The National Cancer Institute recently funded the very first multicenter case-controlled study to investigate certain risk factors.

Risk factors like environmental and genetic factors as well as a person’s quality of life and long-term outcomes with meningioma.

Utilizing the resources and the research data provided by the cancer registry will assist individuals that are eligible for other resources.

The hope and goal of the research are to move forward with the prevention of this disease.

Another goal is to allow the investigations to provide reasons for the tumors and what causes this disease.

There was so much that was not known of this disease and the centers went to change that.

For the more they know then the more the patient and their families will know.

Knowledge is power.

 

Symptoms

Most of the symptoms are subtle and gradual.

These symptoms will begin in a moderate manner and will intensify as time goes by.

No matter what you do or take there just does not seem to be any relief.

Things will just keep getting worse.

Some symptoms depend solely on the location and size of the tumor.

Keep in mind that just because you may be experiencing one or more symptoms does not necessarily mean that you have a tumor.

You should by all means contact your primary care physician and set up an appointment to be checked.

One must remember that most cases of meningioma never experienced any symptoms.

A person can live years with a tumor and not know it but then one day something changes.

Some individuals may never exhibit any signs or symptoms before or after they are diagnosed, there will be several warning signs that should not be ignored.

Warning signs can vary immensely because each type of meningioma develops in different spots on the spinal cord or brain.

There are various types of meningioma with each one affecting different areas or regions of the body.

Each symptom or a combination of symptoms will assist in the categorizing of the type of tumor.

  • Vision loss. Pupils will be uneven and vision will be blurry at the onset.
  • Hearing loss. Sounds will be muffled feeling as if one is wearing headphones.
  • Vertigo.
  • Seizures, not to be confused with muscle spasms or epileptic seizures.
  • Trouble thinking clearly or bouts with memory loss.
  • Issues regarding balance and walking steadily.
  • Excessive body fat can increase the risk.
  • Loss of smell.
  • Sinusitis.
  • Psychiatric issues.
  • Nausea for no apparent reason.
  • Weakness in a leg or an arm. Very seldom will it be in both arms and both legs.
  • Muscle spasms in legs and arms.
  • Abnormal sensations in arms and legs generalizing one side of the body. Such as tingling or numbness.
  • Headaches that will worsen over a period of time.

In 2012 it was proven that the use of cell phones proved to have no related cause.

 

Diagnosis and Stages

The detection and diagnosis of a meningioma can only be accomplished by an imaging test but first, the patient must go through certain procedural steps prior to an imaging test.

Many physicians wish to rule other medical issues out beforehand.

Many diagnoses are made when the physician is looking for something completely different.

First, the primary care physician will perform a full physical of the patient.

This exam will gather as much information regarding the patient as possible.

Information regarding family history is a critical part of the exam.

Then the patients’ vision and reflexes will be tested.

A neurological exam will then take place.

Here the patient will have his or her hearing tested as well as their reflexes once again.

The next step is checking their balance and coordination by issuing the patient to walk certain ways and attempting to perform certain tasks.

Mental exams are next to observe the patient’s ability to recall orders and how to perform them.

The entire time these tests are being performed, the patient is being carefully observed.

Even if the patient is quiet they are being watched.

After the completion of these tests and exams, it will then be determined to set up appointments to have the patient receive imaging testing.

Each imaging test reveals something different than the next one.

Many people assume that they are just redundant in testing but this cannot be further from the truth.

A CAT scan or CT scan is a computerized tomography scan and it takes x-rays that will create a cross-sectional image of your head and brain.

These cross-sectional images are described to be like slices of your head and brain which will be combined together to create an entire image.

Each slice or image is detrimental to the full picture because each one holds something different from the other.

There will be times when the picture needs to be augmented further and then an iodine-based dye will be injected or given.

Another imaging test is the MRI scan or magnetic resonance imaging.

This imaging involves a large cylinder that is a huge magnet.

The patient will lie down on the table and the machine will slowly move them into the cylinder.

A magnetic field and radio waves will be used to create a cross-sectional image or images within your brain.

An MRI gives a much broader and detailed picture of the brain and meningiomas.

Again there may be incidences where there must be augmented pictures and the dye will be administered to the patient.

Once all of the required tests are performed the physicians will read the results and look at the pictures.

They will look for radiological characteristics within the images such as an indentation of the brain and a dural tail which is an attachment that may be obvious at the covering of the brain.

Every out of place or obscure spot is investigated further.

If a tumor has been detected by the imaging, a pathological confirmation or biopsy of the tumor is required.

That biopsy sample or piece of tissue will be sent out to be examined.

The examination will verify or confirm if there are certain pathological cell characteristics involved and will assign a grade level or stage to the tumor.

Staging is a particular way that physicians may describe where a tumor is located.

Staging also indicates if the tumor is cancerous and can it or how far it has spread.

It also will indicate the severity of how it may be affecting other parts of the patients’ body.

There is no formal system for staging meningioma because central nervous system tumors cannot be staged in the same way as any of the other types of tumors.

Meningioma is listed as grades or type rather than in stages.

Physicians will use a patients’ medical history and risk factors to assist in grading the tumor.

Grade I will require complete removal of the dural tail and all other associated tissues, along with resection of the underlying bone.

Surgery type for this grade tumor is a traditional approach craniotomy or what is known as a skull-based surgery.

Grade II will require complete coagulation or creating a blood clot and removal of the dural attachment.

Coagulation is necessary so that the damaged blood vessel can be replaced or repaired.

This also aids in recent blood loss that occurred during surgery.

Grade III will require complete removal but without the coagulation or the resection of the dura.

Grade IV will require subtotal resection.

This is described as only removing a part of or a portion of the tumor.

This type of surgery may only require a minimally invasive procedure like transnasal endoscopic surgery.

Staging and testing allow the physicians to determine what kind of treatment is best or what treatment will assist in predicting the outcome of the patients’ prognosis.

Before and after treatment is crucial to the overall recovery process.

The importance of staging and testing also provides the opportunity to see how large the tumor is because some tumors have been known to be the size of a grapefruit.

 

Treatments and Drugs

Treatment of any form of meningioma tumor depends solely on a handful of factors.

For instance, the size and exact location of the tumor, the patients’ overall health, and the patients’ goals for his or her treatment.

There are times when immediate treatment is not the best choice for a patient.

This is true, especially for the slow-growing tumor.

If the tumor is not causing the patient any discomfort then the decision may be made to just wait.

Sometimes a wait and see approach is done just to see if the tumor grows.

If the patient and physician have decided to opt-out of treatment for whatever reason, then periodic brain scans will be performed to evaluate if the tumor has grown in size.

The patient has several options if it has been determined that evidence has been indicated the growth of the tumor.

There are surgery, radiation therapy, and fractionated radiation.

Let us not fail to mention that the patient can also request seeking out alternative medicine.

Surgery: complete or partial removal of a mutated area.

Radiation therapy uses a photon beam to zap away the tumor.

This is generally used after subtotal or total resections have been completed.

These lasers will assist in removing small particles of cancerous tissues that could not be removed during surgery.

Many times there are particles that cannot be removed due to location or maybe too minuscule to cut away.

Radiosurgery is a type of radiation treatment that uses a far more powerful beam of radiation that is pointed directly at a precise area.

Even though it is titled surgery, there is no use of scalpels and no incisions are made.

This type of procedure is done strictly as an outpatient and can be completed in mere hours.

This type of treatment is generally recommended and used for people that have a meningioma that cannot be removed through conventional surgery.

It is also used for tumors that keep reoccurring.

Fractionated radiation: Tumors that are located in an area that will not or cannot tolerate the high intensity of radiosurgery, have this option.

Tumors that may be too large for radiology will opt for this treatment.

Fractionated radiation delivers small fractions of radiation over a set amount of time like once every day for thirty days.

Alternative medicine: many people do not like surgery and will steer towards nature’s way of dealing with the matter.

Patients must remember and know that alternative medicine does not treat meningioma but it can provide some relief from side effects caused by other treatments.

Methods of alternative medicine are acupuncture, massage, music therapy, meditation, and hypnosis.

Patients can also find relief in music therapy and relaxation exercises which work superbly for the added stress the patient may be under during the whole ordeal.

If one should choose alternative medicine for the relief they should discuss all options with their primary care physician or oncologist to determine which one is best suited for them.

You should choose something that will have positive end results with the least amount of stress.

Chemotherapy has not proven to a reliable choice so therefore it is normally not offered.

As of the present, there is a very limited choice in the drug category.

This is solely due to the fact that any form of the medication does not help nor hinder the patients’ health or outcome.

Drugs are typically used with patients that experience reoccurring Meningiomas and have proven unresponsive to prior treatments.

Patients that have previously been through surgery and radiation can be prescribed medications that may assist them.

Physicians may only prescribe medication if all attempts at previous treatments and options have failed.

The medications generally prescribed are used that will inhibit the tumors ability to recruit blood vessels and prevent any release of a growth hormone.

Medications like somatostatin analogs, hydroxyurea, and angiogenesis have shown some promising results.

Continuous and life-long monitoring for regrowth or reoccurrences of tumors must be expected by the patient.

Research has shown that once one has been diagnosed with meningioma the odds of reoccurrence are high.

 

Coping and Support

Learn everything that you can about Meningioma.

Educate yourself by reading books and pamphlets regarding your condition.

Do your research but use extreme caution about what internet websites you go to.

Visit only the ones that are reputable and well-known.

Go to the library and check out some books that discuss your condition.

Ask your physician for some suggestions. Stay informed.

Ask questions. This cannot be emphasized enough.

Be prepared for all of your physician visits and ask questions.

If something is said or shown that you do not understand then stop the physician and ask questions.

They are there for you since you are the one going through this ordeal.

Your care team is crucial to your recovery.

Build a support network.

This network would or should include your pastor or spiritual leader.

Get in touch with support groups in your area which you can locate online, or through the cancer society.

Talk to a psychologist and social worker.

Take care of yourself. Keep your stress down as much as possible.

This is where the support network will help a great deal.

Maintain a diet of fresh fruits and vegetables because they hold some valuable nutrients your body requires.

Some of the medications may drain you of viable nutrients.

Moderate exercise is advised only if your physician permits you.

Get outside and breathe the fresh air.

Let the sunshine on your face and feel the wind in your hair.

Listen to the birds’ chirp. Go to lunch with a friend.

Take a leisurely walk around a park.

It does not matter what you do as long as you get outside for a few minutes each and every day.

Even if it is raining, this has proven to be beneficial in a patient’s health and recovery process.

Get a coloring book and crayons and color.

Keep a journal.

Writing down your thoughts can assist you to relieve some stress and will also help you remember some questions that you may have for your physician.

A journal is also helpful with your support group because you can discuss certain things that you may not be able to state to friends and family.

Do not isolate yourself from friends or family for they are your main support lifeline.

They will know if you are acting differently than at any other time.

They can help you remember things that may slip your mind.

Utilize them as much as possible.

Remember that you are not a burden to them, as many of them do want to help you.

They feel like they will be a bother to you so keep the line of communication open.

This is a crucial aspect from start to finish. Talk and ask.

Keep in mind that you are not alone.

Surround yourself with people that care.

Technology and research have become so advanced in the past few years which allows for longer mortality and morbidity.

Being diagnosed with this does not mean the end of the world.

Do your research on what is readily available to you and use what you know.

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The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.

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