A meningioma is a tumor that arises from the meninges — the membranes that surround your brain and spinal cord. Most meningiomas are noncancerous (benign), though, rarely, a meningioma may be cancerous (malignant). Some meningiomas are classified as atypical, meaning they’re neither benign nor malignant, but rather something in between.
Meningiomas occur most commonly in older women. But a meningioma can occur in males and at any age, including childhood.
A meningioma doesn’t always require immediate treatment. A meningioma that causes no significant signs and symptoms may be monitored over time.
Signs and symptoms of a meningioma typically begin gradually and may be very subtle at first. Depending on where in the brain or, rarely, spine the tumor is situated, signs and symptoms may include:
Changes in vision, such as seeing double or blurriness
Headaches that worsen with time
Weakness in your arms or legs
Most signs and symptoms of a meningioma evolve slowly, but sometimes a meningioma requires emergency care. It is important to seek emergency care if you have a sudden onset of seizures or sudden changes in your vision or memory. It is most o advisable and to visit your doctor if concerning signs and symptoms such as headaches, worsen over time.
It isn’t clear what causes a meningioma. Doctors know that something alters some cells in your meninges — the membranes that form a protective barrier around your brain and spinal cord — to make them multiply out of control, leading to a meningioma tumor. But whether this occurs because of genes you inherit, things you’re exposed to in your environment or a combination of both remains unknown.
Risk factors for a meningioma include:
Radiation treatment. Radiation therapy that involves radiation to the head may increase the risk of a meningioma.
Female hormones. Meningiomas are more common in women, leading doctors to believe that female hormones may play a role.
An inherited nervous system disorder. The rare disorder neurofibromatosis type 2 increases the risk of meningioma and other brain tumors.
A meningioma and its treatment, typically surgery and radiation therapy, can cause long-term complications, including:
Your doctor can treat some complications and refer you to specialists to help you cope with other complications.
Treatments and Drugs
The treatment you receive for a meningioma depends on many factors, including the size of your meningioma, where it’s situated and how aggressive it’s believed to be. Your doctor will also take into consideration your overall health and your goals for treatment.
Immediate treatment isn’t necessary for everyone with a meningioma. A small, slow-growing meningioma that isn’t causing signs or symptoms may not require treatment.
If the plan is not to undergo treatment for your meningioma, you’ll likely have brain scans periodically to evaluate your meningioma and look for signs that it’s growing. If your doctor determines your meningioma is growing and needs to be treated, you have several treatment options.
If your meningioma causes signs and symptoms or shows signs that it’s growing, your doctor may recommend surgery. Surgeons work to remove the meningioma completely. But because a meningioma may occur near many delicate structures in the brain or spinal cord, it isn’t always possible to remove the entire tumor. In those cases, surgeons remove as much of the meningioma as possible.
The type of treatment, if any, you need after surgery depends on several factors.
If no visible tumor remains, then no further treatment may be necessary. However, you will have periodic follow-up scans.
If the tumor is benign and only a small piece remained, then your doctor may recommend periodic follow-up scans only. In some cases, small, leftover tumors may be treated with a form of radiation treatment called stereotactic radiosurgery.
If the tumor is atypical or malignant, you’ll likely need radiation.
Surgery may pose risks including infection and bleeding. The specific risks of your surgery will depend on where your meningioma is located. For instance, surgery to remove a meningioma that occurs around the optic nerve can lead to vision loss. Ask your surgeon about the specific risks of your surgery.
If your meningioma can’t be completely removed, your doctor may recommend radiation therapy following surgery. The goal of radiation therapy is to destroy any remaining meningioma cells and reduce the chance that your meningioma may recur. Radiation therapy uses a large machine to aim high-powered energy beams at the tumor cells.
Advances in radiation therapy increase the dose of radiation to the meningioma while reducing radiation to healthy tissue. These include fractionated stereotactic radiotherapy (SRT) and intensity-modulated radiotherapy (IMRT).
Radiosurgery is a type of radiation treatment that aims several beams of powerful radiation at a precise point. Contrary to its name, radiosurgery doesn’t involve scalpels or incisions. Radiosurgery typically is done in an outpatient setting in a few hours. Radiosurgery may be an option for people with meningiomas that can’t be removed with conventional surgery or for meningiomas that recur despite treatment.
For tumors too large for radiosurgery or those in an area that can’t tolerate the high intensity of radiosurgery — such as near the optic nerve — a possible option is fractionated radiation. This involves delivering the radiation in small fractions over time. For example, this approach might require one treatment a day for 30 days.
For people with meningiomas that recur or don’t respond to surgery and radiation, doctors are trying different system treatments. Unfortunately, most chemotherapy has not proved valuable, but some drugs, such as hydroxyurea (Droxia, Hydrea), are sometimes used. Other drugs are being tested as well, such as those that inhibit the formation of blood vessels (angiogenesis inhibitors). Much more study is needed.
Alternative medicine treatments can’t treat meningiomas, but some may help provide relief from treatment side effects or help you cope with the stress of having a meningioma. Alternative medicine therapies that may be helpful include:
Discuss options with your doctor.
Being diagnosed with a meningioma can be overwhelming. To help you cope, try to learn everything you can about meningiomas and build a support network. Take care of yourself. Try to stay healthy during your treatment for a meningioma by taking care of yourself. Eat a diet rich in fruits and vegetables, and get moderate exercise daily if your doctor allows it. Get enough sleep so that you wake feeling rested. Reduce stress in your life by focusing on what’s important to you. These measures won’t cure your meningioma, but they may help you feel better cope with your life.