The membranes that surround the brain and spinal cord, known as the meninges, play a crucial role in protecting the central nervous system. In rare instances, however, the cells within these layers can grow uncontrollably, forming a type of tumor called a meningioma. These tumors typically develop slowly and may go unnoticed for years, but over time, they can put pressure on brain tissue, leading to a range of neurological symptoms.
They can cause vision problems, speech difficulties, memory loss, and seizures. If not diagnosed and treated promptly, they may lead to serious complications. While most are benign, their location and growth rate make careful monitoring essential.symptoms.
Definition: What Is a Meningioma?
A meningioma arises from the meninges, the protective membranes surrounding the brain and spinal cord. It is usually benign, slow-growing, and localized. These tumors are more common in adults, particularly women, and account for nearly one-third of all brain tumors.
Understanding what a meningioma is also involves recognizing its potential effects on surrounding tissues. While they rarely invade nearby structures, they can compress adjacent brain regions and cause significant clinical symptoms. Some are discovered incidentally during imaging for unrelated conditions.
Origin and Growth Rate of Meningiomas
These tumors most commonly originate in the dura mater, the outermost layer of the meninges. Although many grow slowly, their impact depends on their size and location. Some remain symptom-free for years, while others lead to increased intracranial pressure and neurological changes in a shorter time frame.
Are Meningiomas Cancerous?
Although the majority are non-cancerous, a few subtypes are malignant. According to the World Health Organization (WHO), classification is as follows:
• Grade I: Benign (most common)
• Grade II: Atypical (more aggressive)
• Grade III: Anaplastic/Malignant (most aggressive, highest recurrence risk)
Higher-grade tumors have a greater potential to recur and may spread to nearby tissues, requiring close follow-up.
Causes and Risk Factors for Meningioma
The exact causes of meningiomas are still not fully understood; however, genetic, environmental, and hormonal factors are believed to play a role in their development.
Primary Risk Factors for Meningioma Development Include:
- Genetic Predispositions: Inherited conditions such as Neurofibromatosis Type 2 (NF2) are linked to an increased likelihood of developing these tumors. People with NF2 may develop multiple growths over the course of their lives.
- Radiation Exposure: Previous radiation therapy to the head or neck area significantly increases the risk.
- Hormonal Influences: The higher incidence in women, along with the presence of hormone receptors on some tumors, suggests a connection between hormones—particularly estrogen and progesterone—and abnormal cell growth.
Radiation Exposure and Hormonal Factors in Meningioma Development
The exact causes of meningiomas are not fully understood; however, genetic, environmental, and hormonal factors are believed to play a role in their development.
Primary Risk Factors for Meningioma Development Include:
Genetic Predispositions
Conditions such as Neurofibromatosis Type 2 (NF2) are linked to an increased risk of developing meningiomas.
The Impact of Radiation
Exposure to ionizing radiation, especially during childhood, is a significant risk factor for developing this tumor type.
Hormonal Influences
These tumors are more frequently diagnosed in women, which points to a possible link between female hormones and tumor growth. Some contain estrogen and progesterone receptors, suggesting hormonal involvement.
Common Signs and Symptoms of Meningioma
Symptoms depend on tumor size, location, and the pressure exerted on surrounding tissues. Some remain asymptomatic for years, while others cause early symptoms.
Symptoms Based on Tumor Location
• Frontal lobe tumors can lead to cognitive and behavioral changes.
• Tumors near the cerebellum may affect balance and coordination.
• Spinal involvement can cause numbness, weakness, or bladder and bowel issues.
Common Neurological Symptoms
• Headaches, often worse in the morning
• Seizures
• Nausea and vomiting caused by intracranial pressure
Visual and Auditory Disturbances
Compression of the optic nerve may lead to vision loss or double vision. Tumors near the auditory nerve can cause tinnitus, hearing loss, or vertigo.
Headaches and Seizures as Warning Signs
Persistent headaches or seizures can be the first indication of this condition, often leading to diagnosis.
How Is Meningioma Diagnosed?
Diagnosis typically involves imaging studies prompted by neurological symptoms.
Neurological Examination
A detailed assessment of reflexes, balance, speech, and coordination helps detect abnormalities suggestive of a brain tumor.
Imaging Techniques for Meningioma
• MRI is the most accurate tool for evaluating tumor size and location.
• CT scans may help identify calcification.
Biopsy for Definitive Diagnosis
If malignancy is suspected, a surgical or needle biopsy may confirm tumor type and grade to guide treatment.
Types and Classification of Meningioma
According to the WHO, classification depends on cellular structure, growth rate, and recurrence likelihood.
• Grade I: Benign
• Grade II: Atypical
• Grade III: Malignant
These distinctions are important for creating the most effective treatment plan.
Common Subtypes of Meningioma
• Fibrous meningioma – firm and slow-growing
• Microcystic meningioma – soft and fluid-filled
• Psammomatous meningioma – contains calcified psammoma bodies
These distinctions guide treatment strategies for each meningioma case.
These classifications are essential for developing an effective treatment strategy for meningioma.
Meningioma Treatment Options
Treatment depends on tumor size, location, and patient health. Options include:
• Surgical removal
• Stereotactic radiosurgery
• Radiotherapy
• Chemotherapy (in rare or aggressive cases)
Surgical Treatment
Surgery is the primary approach and aims to remove as much of the tumor as possible while preserving neurological function.
Radiotherapy for Meningioma
Used when tumors cannot be fully removed or recur after surgery.
Chemotherapy in Meningioma Treatment
Limited use, typically for higher-grade or treatment-resistant tumors.
Key Factors Influencing Meningioma Treatment Options
WHO tumor grading (Grade I, II, III)
- Tumor location and its proximity to critical brain structures
- Risk of recurrence
- Patient age, general health status, and underlying medical conditions
What You Should Know About Meningioma Surgery
Surgery requires careful preoperative and postoperative management by an experienced team.
Preoperative Preparation
- Neurological and general health assessments
- Blood tests, advanced imaging studies, and a comprehensive anesthesia evaluation
- Detailed patient education and consent
Surgical Procedure
Performed under general anesthesia, involving a small skull incision for tumor removal. Duration depends on tumor size and location.
Postoperative Expectations and Recovery
- Hospital stay ranges between 3 to 7 days
- Headaches, fatigue, or mild nausea may be experienced during the first few days after surgery.
- Full recovery typically takes weeks to months
- Follow-up MRI scans are used to monitor for recurrence
Robotic Surgery for Meningioma
In select centers, robot-assisted surgery is performed for tumors located near the skull base or in challenging areas. This approach offers greater precision through smaller incisions, enhancing both safety and recovery time.
Life After Meningioma Treatment
Following treatment, patients generally return to their daily routines with proper follow-up care. Regular imaging, neurological evaluations, and rehabilitation programs help maintain long-term health and minimize recurrence risk.
* Liv Hospital Editorial Board has contributed to the publication of this content .
* The contents of this page are for informational purposes only and are not a substitute for professional medical advice. Please consult your doctor for diagnosis and treatment. This page does not provide information on medical services or healthcare offered at Liv Hospital.
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Frequently Asked Questions
Can it recur?
Yes. Certain types, especially atypical (Grade II) and malignant (Grade III), have a higher chance of recurring even after complete surgical removal. For this reason, ongoing regular monitoring is essential.
Is hair shaved during surgery?
Depending on the surgical approach, a small area of hair may need to be shaved. However, modern techniques minimize hair removal and focus on achieving optimal aesthetic results. Hair usually regrows quickly, and any scars generally fade over time.
What is the life expectancy after diagnosis?
Life expectancy after a meningioma diagnosis is influenced by the tumor type, its location, the patient's age, and overall health. Most benign meningiomas have excellent outcomes, with patients often living for many years. Malignant meningiomas usually require more aggressive treatment and close, ongoing follow-up.
Is a meningioma benign or malignant?
Most cases are benign; however, certain subtypes can exhibit more aggressive behavior. A definitive pathological evaluation after diagnosis is essential to determine the tumor grade, which directly informs and guides the appropriate treatment plan.
Can it shrink on its own?
Small, asymptomatic cases often remain stable and, in rare cases, may even shrink over time. However, regular monitoring is essential, as many of these tumors eventually show slow growth if left untreated.