Meningiomas

Meningiomas are the most common type of primary brain tumor, representing about one-third of all brain tumors. These typically benign (non-cancerous) brain tumors develop from the meninges, the protective membranes that cover the brain and spinal cord. While most meningiomas grow slowly and are noncancerous, they can still exert pressure on the brain, nerves, or spinal cord and cause neurological problems. 

Some meningiomas remain small and never cause any symptoms.   They are frequently discovered on routine MRIs of the brain. They are often small, and a follow-up MRI will confirm that the meningioma is dormant.  Others will grow and cause symptoms that require treatment.  Evaluation by an experienced neurosurgeon is important to prevent complications and improve outcomes. 

What Are Meningiomas? 

Meningiomas originate from cells within the meninges, which is part of the protective covering of the brain and spinal cord.   They can occur anywhere a part of the central nervous system comes into close contact with the skull or spinal column.  Most meningiomas are WHO Grade I, which are benign, and if removed completely can be cured with surgery.  Grade 2, atypical, tumors can be cured with surgery but have much higher rates of recurrence.  Grade 3 meningiomas are malignant (cancerous).   They require aggressive surgery, postoperative radiation and often chemotherapy.  Fortunately grade 3 tumors are rare, but they are difficult to cure. 

Meningiomas can occur in various parts of the brain, including: 

• Convexity (top of the brain) 
• Skull base 
• Behind the eyes (olfactory groove) 
• Along the spinal column 
  
  

They are usually solitary, but some genetic conditions predispose patients to developing more than one meningioma.    This can occur in neurofibromatosis type 2 (NF2). 

Who Gets Meningiomas and When? 

Meningiomas are most often diagnosed in: 

• Adults aged 40–70 
• Women, due to the fact that meningiomas frequently express sensitivity to progesterone and estrogen, the female hormones. 
• African American populations 
  
  

These tumors are rare in children but tend to be more aggressive when they occur.  

Many meningiomas are discovered coincidentally during evaluations for unrelated issues, especially as MRI imaging has become common. 

What Causes Meningiomas? 

The precise cause of meningioma tumors is not fully understood. However, a combination of genetic, hormonal, and environmental factors may contribute to their development. 

Risk Factors for Meningiomas 
Several known and suspected risk factors include: 

• Radiation exposure: Particularly to the head and neck, often from prior medical treatment. 
• Hormonal influence: Presence of estrogen and progesterone receptors in some tumors suggests a link, especially in women. 
• Genetic conditions: Especially neurofibromatosis type 2 (NF2), which significantly increases risk. 
• Family history: Rare, but familial cases have been reported. 
• Obesity and metabolic factors: May play a role in tumor development, though more research is needed. 

What Are the Signs and Symptoms of Meningiomas? 

Because they usually grow slowly, symptoms of meningioma may develop gradually. Symptoms depend on the tumor’s size and location and may include: 

• Persistent or worsening headaches 
• Seizures 
• Vision changes (blurry or double vision) 
• Hearing loss or ringing in the ears 
• Memory loss, confusion, or personality changes 
• Numbness, weakness, or coordination problems 
• Speech difficulties 
• Nausea or vomiting (from increased intracranial pressure) 
• No symptoms (small meningiomas discovered coincidentally) 

How Are Meningiomas Diagnosed? 

A diagnosis of meningioma typically involves: 

• Neurological examination to assess reflexes, muscle strength, coordination, and cognitive function. 
• Imaging tests, especially: 
  
  • MRI (Magnetic Resonance Imaging): The most sensitive tool for detecting brain tumors.   meningiomas create a very characteristic MRI  picture and often the diagnosis can be made directly at the time of imaging. 
  • CT scans: Useful when MRI is not possible or for detecting calcified tumors. 
    
    

Advanced techniques like functional MRI or perfusion imaging may also be used to evaluate the tumor’s impact on brain function and blood supply. 

How Are Meningiomas Treated? 

Treatment for meningiomas depends on tumor size, grade, location, symptoms, and overall patient age and health. Management may involve active monitoring or a combination of surgery and radiosurgery. 

Observation 
For small, asymptomatic (no symptoms) meningiomas, especially in older adults, "watchful waiting" with periodic MRIs may be appropriate. 

Radiation Therapy 
Radiosurgery for meningiomas is often recommended: 

• After surgery to reduce the likelihood of recurrence 
• As a primary treatment for deep-seated tumors 
• Utilizing the Gamma Knife, a highly focused radiation technique that targets the tumor while avoiding damage to surrounding normal brain tissues 
  
  

Brain Tumor Surgery 
Surgery to remove the meningioma is often the first-line treatment for tumors that are accessible and causing symptoms.  The goal is to remove as much of the tumor as safely possible: 

• Complete resection (gross total removal) can be curative for benign tumors. 
• Partial removal (subtotal resection) may be necessary if the tumor is near critical structures, followed by radiosurgery. 
  
  

Recovery and outcomes after surgery depend on tumor location, patient health, and the surgeon’s skill.  Meningiomas can wrap themselves around critical blood vessels and nerves within the brain and spinal cord.  It requires delicate surgical technique to remove meningiomas without damaging these structures. 

Medication 
Medications may help manage symptoms: 

• Antiepileptic drugs to control seizures 
• Corticosteroids to reduce tumor related swelling and edema 
  
  

Chemotherapy and hormone therapy are not standard for most meningiomas but may be used in select, aggressive cases. 

Expert, Personalized Care for Meningiomas 

If you or a loved one has been diagnosed with a meningioma, our expert team is here to provide cutting-edge care and compassionate support.  

Contact us today to schedule an appointment or learn more about your treatment options.