Meningiomas are tumors that develop from the covering of the brain and spinal cord called the meninges. These are typically benign tumors though malignant forms can exist as well. Typically symptoms are due to compression, irritation or edema in the surrounding neural tissue.
It is believed tumors may either grow at a slowly progressive rate or in in spurts. Some may grow more rapidly. It is difficult to determine how long a meningioma has been present for as it is usually not detected until it reaches a clinically significant size.
What symptoms do they cause?
These tumors can cause a variety of symptoms based on their location, their association with the local neurologic structures and any associated edema or swelling. Some tumors are found incidentally and are asymptomatic while others cause a variety of neurologic signs and symptoms. Symptoms can include headache, blurry vision, loss of vision, change in sense of smell, difficulty with eye movement, facial numbness, tingling, pain, weakness, decrease or loss of hearing, difficulty swallowing, pituitary dysfunction, numbness, weakness, balance issues and seizures.
Where are they typically located?
Most patients will have a single tumor, but some patients multiple tumors maybe present. These can occur in multiple locations in the central nervous system.
Some location include:
Suprasellar Skull Base
Parasaggital / Falcine
What treatment options are there?
Treatment depends on symptoms, locations and involvement of surrounding structures. Patients may have to options of observation, surgery or radiosurgery. Surgical approaches may include traditional cranial approaches versus newer endoscopic transnasal approaches with sometimes no incisions what so ever.
Cranial approaches to menigiomas involved removal of the associated tumor, bone and meninges. These may require skull base approaches if the tumors are located in this location.
Endoscopic surgery is often performed as team surgery where working through the nasal corridors and sinuses the tumor is accessed directly at the base of the skull avoiding brain retraction and done without incisions in the scalp or face.
Stereotactic Radiosurgery provides focused radiation to the tumor and minimizes radiation exposure to the local neurovascular structures. It can be very effective in the local control of these tumors and can be combined with surgical treatment when necessary or be performed as a primary treatment.
A number or factors will help determine the optimal treatment paradigm. Our team of neurosurgeons can aid in navigating among the options and provide a treatment plan tailored to you.