Tumor of meningioma

 

 

Tumor of the meninges ( meningioma)

Location MRI Image Common Symptoms
Convexity (on the surface of the brain away from the midline) Seizures, headache, extremity weakness, difficulty speaking, visual field deficit.
Parafalcine (arising the meningeal layer between the hemispheres of the brain) Seizures, lower extremity weakness, headache, personality changes, dementia, increasing apathy, flattening of affect, unsteadiness, tremor.
Sphenoid Ridge Eye-bulging, decreased vision, paralysis of eye movement, seizures, memory difficulty, personality change, headache.
Posterior Fossa (area where the cerebellum is) Unsteadiness and incoordination, hydrocephalus (increased pressure inside the brain), voice and swallowing difficulties.
Cerebellopontine angle (on the side of the brainstem) Loss of hearing. Facial muscle weakness. Dizziness. Unsteadiness and incoordination, hydrocephalus (increased pressure inside the brain), voice and swallowing difficulties.
Olfactory Groove and sella (bony space where the pituitary gland is situated) Loss of smell (anosmia), subtle personality changes, mild difficulty with memory, euphoria, diminished concentration, urinary incontinence, visual impairment.
Optic Sheath   Decreased vision in one eye.
Other   Variable depending on location.

 

Diagnosis

 

  • Magnetic resonance imaging (MRI) scans effectively detect most meningiomas and are best at displaying details of the brain.
  • Sometimes a CT scan is obtained to evaluate whether there is any bone (skull) involvement, or if the tumor is calcified.

 

Treatment

 

The decision of whether to, and how best to, treat a meningioma is based on multiple factors, including size and location of the tumor, symptoms, growth rate, and age of the patient (among others). In general, there are three basic options: observation, surgical removal, and radiation.

 

  • Observation: Meningiomas are often slow growing, increasing in size only 1-2 mm per year. Repeating yearly MRI scans may be appropriate in the following situations:
    • Patients with small tumors and mild or minimal symptoms, no impact on quality of life, and little or no swelling in adjacent brain areas.
    • Older patients with very slowly progressing symptoms. Related seizures can be controlled with medication.

 

  • Surgery: Meningioma surgery varies from relatively straightforward to highly complex, sometimes requiring multiple surgeons from different specialties.