Meningioma Treatment & Symptoms

Table of Contents

About Meningioma

Meningiomas are brain tumors that arise from the meninges and push into the brain, covering the brain and spinal cord. Most meningiomas are benign, but some are more aggressive. Some patients have no symptoms, while others will have symptoms arising from pressure on the brain by the tumor. Not all patients require immediate treatment, but those who do require meningioma treatment may need surgery or stereotactic radiosurgery at a Gamma Knife center and/or fractionated radiotherapy.

Meningioma Development

Approximately 98-99% of meningiomas are benign, occurring twice as often in women. Grade II (~8-10%) lesions recur more frequently and are more aggressive, but they are not malignant. Grade III tumors are considered to be malignant (1-2%) and are found more frequently in men. Meningioma development typically occurs during middle age, and female hormones may play a role.

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Symptoms and Diagnosis of Acoustic Neuroma

Symptoms are related to the location of the tumor on the vestibulocochlear nerve and include:

  • Hearing loss and/or ringing one ear
  • Vertigo
  • Balance issues and difficulty walking
  • Facial numbness and weakness
  • Hydrocephalus (a buildup of fluid in the brain)

To confirm the acoustic neuroma diagnosis, a doctor will examine the patient’s ear, give a hearing test and/or use diagnostic imaging techniques (such as computed tomography scans or magnetic resonance imaging).

Symptoms and Diagnosis of Meningioma

Meningioma symptoms depend on the tumor’s size, location and grade, as well as the impacted brain area. Symptoms may include:

  • Headaches
  • Nausea and/or vomiting
  • Seizures
  • Problems with hearing or vision
  • Cognitive and memory issues
  • Muscle weakness

Some patients without symptoms learn of a meningioma incidentally, when the doctor orders tests for another condition. Doctors can detect meningiomas using diagnostic imaging, such as computed tomography (CT) scans and magnetic resonance imaging (MRI).

Categorizing Meningioma

Doctors categorize meningiomas into three grades based on how aggressive they are. Pathologists make this determination by giving patients a biopsy. The three grades are:

  • Grade I/Benign: the most common and least aggressive form
  • Grade II/Atypical: grows quickly than Grade I tumors, includes subtypes:
    • Atypical meningioma
    • Meningioma that has grown into the brain
    • Chordoid meningioma
    • Clear cell meningioma
  • Grade III/Malignant or Anaplastic: the most aggressive form, most likely to return following treatment

Meningioma Treatment

A doctor will recommend a treatment plan for a patient based on the individual’s overall health, tumor grade, size and location. Possible meningioma treatment options include:

  • Monitoring: Doctors use this wait-and-see approach for tumors growing at a slow rate and not showing symptoms.
  • Meningioma Surgery: In most cases, doctors perform meningioma surgery to remove as much of the tumor as possible. Radiation is reserved for those tumors that show regrowth after resection or if some of the tumor cannot be removed safely. Grade II and Grade III lesions may get radiation immediately after surgery without waiting for recurrence.
  • Gamma Knife/Stereotactic Radiosurgery: Using technology such as Leksell Gamma Knife®Icon, doctors deliver focused radiation directly to the tumor while sparing surrounding healthy tissue.
  • Fractionated Radiotherapy: Multiple low-dose radiation sessions are delivered to the meningioma, which is effective in stopping the growth of meningiomas in the majority of cases.

Meningioma Prognosis

The prognosis depends on the patient’s health condition in combination with the tumor grade. Lower-grade tumors are less aggressive and typically carry a more favorable prognosis. However, the doctor will give the patient a personalized prognosis based on their unique condition.

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