The meningioma is usually a benign brain tumor that comes from cells in the covering of the brain and spinal cord. These tumors account for about 20% of all primary brain tumors. They are most often seen in middle-aged women. The vast majority of these brain tumors are benign, however, they can be difficult to remove completely and thus can recur. On rare occasions they can be malignant. Meningiomas are usually single tumors but they can be multiple.
SYMPTOMS
The symptoms of a meningioma depend upon the location of the tumor. Headache, stroke-like symptoms, seizures, loss of vision (particularly in one eye) and personality changes are some of the symptoms seen with these tumors.
DIAGNOSIS
As always, a careful history and physical examination are the first steps in diagnosis. These tumors tend to have a fairly characteristic appearance on CT or MRI scans, which should be performed without and with intravenous contrast enhancement. Sometimes an angiogram (x-ray of the blood vessels) might be performed.
TREATMENT
The treatment of these brain tumors depends on the appearance of the tumor and the medical condition and age of the patient. Surgery is the usual first approach. As these brain tumors tend to compress rather than invade the brain, complete removal is sometimes possible. Unfortunately, even tumors that appear to have been completely removed can, with time, recur. Occasionally, radiation therapy or stereotactic radiosurgery might be recommended for residual tumor. Some tumors may be observed with serial CT or MRI scans and some tumors might be treated with stereotactic radiosurgery instead of open surgery. Malignant meningiomas should have surgery followed by radiation therapy.