Meningioma – Causes, symptoms, and management

Meningioma – Causes, symptoms, and management

Boden Lam

A meningioma is a type of tumor that develops in the meninges—the protective membranes surrounding the brain and spinal cord. While most meningiomas are non-cancerous (benign), they can cause significant health complications due to their location and potential growth. Hence, those who experience the symptoms should not delay visiting a healthcare professional. This guide provides a brief overview of the condition’s common warning signs, causes, and treatment options for better management.

What is a meningioma?
A meningioma is a tumor arising from the meninges, the three layers of protective tissue surrounding the brain and spinal cord. It accounts for approximately 30% of all primary brain tumors and is more common in women than men. Although typically slow-growing and benign, meningiomas can cause symptoms and complications due to their size and location.

What are its causes and risk factors?
While the exact cause is still not fully understood, researchers have identified several potential risk factors:

Genetic predisposition
Genetic predisposition plays a role in some cases. Individuals with specific inherited conditions, such as neurofibromatosis type 2 (NF2) and familial meningiomatosis, have a higher risk of developing meningiomas.

Hormonal factors
Fluctuations of hormones like estrogen and progesterone may contribute to the disorder’s development. As a result, the risk is higher in women, especially during reproductive years.

Radiation exposure
Exposure to ionizing radiation has been linked to an increased risk of developing meningioma later in life. This includes radiation from radiation therapy undergone for head or neck cancer. The risk is higher when the treatment is received at a young age or in high doses.

What are the signs and symptoms of a meningioma?
The signs and symptoms can vary depending on the tumor’s location, size, and proximity to critical brain structures. Some common indicators are:

Headaches
Frequent and severe headaches are a common symptom. These headaches may worsen over time and be accompanied by discomforts like nausea, vomiting, and sensitivity to light.

Seizures
Seizures can occur when a tumor irritates or compresses the brain tissue. Their type and severity can vary, ranging from brief episodes of altered consciousness to more severe convulsions.

Neurological deficits
Meningiomas can exert pressure on surrounding brain structures, leading to neurological deficits. These deficits may manifest as difficulty speaking or understanding language, vision problems, changes in coordination or balance, and weakness, numbness, or tingling in specific body parts.

Cognitive and behavioral changes
Meningiomas in specific brain regions can cause cognitive and behavioral changes, such as memory problems, difficulty concentrating, mood swings, personality changes, and impaired judgment.

Vision and hearing disturbances
Meningiomas near the optic nerves or auditory pathways can result in vision and hearing disturbances like blurred vision, double vision, loss of peripheral vision, hearing loss, and ringing in the ears.

How is the condition diagnosed?
When a meningioma is suspected, the healthcare provider analyzes the patient’s health history and performs a physical examination to identify the symptoms and potential risk factors associated with the tumor. This may be followed by imaging tests to assess the growth’s characteristics. Common imaging techniques include:

Magnetic resonance imaging (MRI)
An MRI uses powerful magnets and radio waves to create detailed brain and spinal cord images. It provides valuable information about the tumor’s size, location, and features.

Computed tomography (CT) scan
CT scans use X-rays to produce cross-sectional images of the brain, providing additional information about the tumor’s characteristics.

Sometimes, a biopsy is performed to confirm the diagnosis and determine the tumor’s histological subtype. It involves extracting a sample of the tumor tissue and examining it under a microscope by a pathologist.

How are meningiomas treated?
The choice of treatment depends on several factors, including the tumor’s size, location, histological subtype, and the patient’s overall health. The main options include:

Observation
The healthcare provider may recommend observation if the growth is tiny and slow-growing and does not cause significant symptoms. Regular imaging scans are performed to monitor the tumor’s growth and assess the need for further intervention.

Surgery
Surgical removal of the meningioma is often the primary treatment approach. The goal is to remove as much of the tumor as possible while preserving neurological function. Different surgical techniques may be employed, such as craniotomy and minimally invasive procedures like endoscopic surgery.

Radiation therapy
Radiation may be recommended after surgery to destroy any remaining tumor cells and reduce the risk of recurrence. It may also be used as the primary treatment for meningiomas that are inoperable or those with a higher risk of recurrence.

Targeted therapies and clinical trials
Researchers are continually exploring targeted therapies and participating in clinical trials to develop more effective treatments for meningioma. These therapies target specific molecular pathways involved in tumor growth and progression.

Besides the above, treatments may be prescribed to control the symptoms associated with the condition, such as seizures, headaches, and hormonal imbalances.

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