What is a Meningioma?

A meningioma is a slow growing, usually benign tumor of the brain or spinal cord. Approximately 98% of all meningiomas are benign, and 99% occur in the head. Meningiomas account for 14-19% of all brain tumors and the peak incidence is 45 years of age. Female to male ratio is 2:1.
Meningiomas most commonly grow inward causing pressure on the brain or spinal cord.

What causes  meningiomas?

Although meningiomas are called brain tumors, they do not grow from brain tissue. They arise from the meninges- the thin layer of tissue covering the brain and spinal cord. The specific cause of meningiomas is unknown.

How do meningiomas typically present? What are the signs and symptoms of meningiomas?

The signs and symptoms vary dramatically depending on the location and size of the meningioma. Alternatively, it would not be unusual to find the meningioma  incidentially, or without associated symptoms.
The first symptoms are usually due to increased pressure caused by the growing tumor. Symptoms of meningiomas in the brain can include seizures, headache, inability to smell, visual loss, double vision, facial weakness or numbness, unilateral hearing loss, personality changes, balance problems, etc.. Symptoms of meningiomas in the spinal cord can include pain, extremity weakness or numbness, etc.

How is a meningioma diagnosed?

The best imaging study used to detect a meningioma is an MRI with contrast. Confirmation of meningioma is done with actual tumor tissue examined by a pathologist under the microscope.

What are the treatment options for meningiomas?

There are three treatment options for meningiomas. They include:

Observation

Monitoring for possible growth with yearly MRI’s is an option best suited for a patients who have small lesions and are elderly.

Radiation

There are many types of radiation available to treat meningiomas and your physician would determine the best type to treat your lesion. A few of the different types include Gamma Knife, Cyber Knife, and Conventional External Beam radiation. ((Robin, will need to link to Gamma and Cyber info)) The goal of radiation would be to keep the meningioma from growing. Rarely the tumor does get smaller but this is not an expected result.
This option is best for patients who have  multiple medical problems, therefore making surgery too risky. Additionally, patients who have residual meningioma after surgical debulking are excellent candidates for radiation.

Surgery

The surgical approach and risks involved vary dramatically depending on meningioma location, size, and vascular supply.

The goal of surgery would be to SAFELY resect as much tumor as possible. It is always best, if necessary,  to leave some tumor behind in order to preserve full neurologic function post-operatively.
This option is best for a young patient or someone who has a large meningioma.

What is the prognosis for meningioma patients?

Most meningiomas are benign, and are treated with surgery and/or radiation.  The long term outcome is typically excellent for these patients. It is not unusual to obtain a surgical cure to where follow-up imaging would not be required. Otherwise, yearly MRI scans in addition to yearly visits to your neurosurgeon will help keep close monitoring of a radiated or non-treated meningioma.

Who do I call if I have questions?

You can call USC Department of Neurosurgery at (323) 442-5720.