Meningioma

Meningiomas grow slowly, often without any noticeable symptoms. Most people with a meningioma experience no symptoms at all. Any noticeable signs will be similar to other neurological disorders:

• Headaches
• Muscle weakness
• Nausea and vomiting
• Vision changes
• Hearing loss or ringing in the ears
• Behavioral changes
• Confusion
• Seizures

The type and severity of symptoms varies depending on the size and specific location of the lesion. About 20% of meningiomas occur on the frontal lobe of your brain, eventually causing seizures, headaches, or vision problems if it grows unchecked. A lesion that grows between the two halves of your brain can disrupt blood circulation.

Women over 65 have the highest risk for developing a meningioma, and it is rarely found in children. Patients with certain genetic disorders have a higher risk of developing meningiomas. People who have been exposed to ionizing radiation are more likely to develop the condition. Pregnancy can cause an existing meningioma to grow faster.

Your doctor might detect a meningioma while running an MRI or CT scan for an unrelated issue. If the lesion is small and doesn't interfere with brain functions, you may not need treatment—just a thorough neurological exam and close observation.

If the tumor continues to grow or you notice symptoms, you might need a surgical resection. A neuropathologist will examine cells from your tumor to determine whether it is benign or cancer.

Your care team will "grade" your meningioma: The lower the grade, the lower the risk of recurrence and aggressive growth. The meningioma scale includes three grades:

• Grade 1: 83% of cases
• Grade 2: 15% of cases
• Grade 3: 2% of cases

From there, your neuropathologist will do molecular testing for specific variations. There are 15 different subtypes of meningiomas.

Observation

If your meningioma is benign, your doctor may recommend active surveillance.

Medication

Your neurologist might prescribe a steroid to reduce inflammation or an epilepsy medication to prevent seizures.

Radiation therapy

Your doctor may recommend radiation therapy, such as proton or photon therapy, to eliminate or shrink cancer cells. Your therapy will be managed by a radiation oncologist, a doctor who specializes in the use of radiation to treat cancer. The type you get depends on your individual cancer treatment plan developed by your care team. Following treatment, you will have periodic scans to determine how your cancer responded to the radiation therapy.

Surgery

The medical term for brain surgery is "craniotomy." When you hear your care team talking about a "resection," it means removing all or part of a tumor, as well as the fibrous tissue that's holding it in place. The tumor might be hard to reach, near important blood vessels, or connected to delicate areas of your brain or spinal cord.

Your neurosurgery team will perform an extensive evaluation to recommend the best kind of surgery for you. Options include:

• Microsurgery: The neurosurgeon uses an operating microscope, specialized instruments, and advanced techniques to surgically remove the tumor.
• Neuroendoscopy: The tumor is removed through your nose using an endoscope (a thin, flexible lighted tube equipped with a high-definition camera). The procedure typically doesn’t require any incisions and usually means a shorter hospital stay and less recovery. At MedStar Health, this procedure is performed as a team surgery, with ENT (ear, nose, and throat) specialists and neurosurgeons working side by side.