What kind of tumor is this and what types of tumors it occurs
The tumor develops from the cells of the arachnoid membrane of the brain and attaches to the dura mater. It grows outside of the brain tissue, so it remains asymptomatic for a long time. Pathologists divide meningiomas into three degrees of malignancy: the vast majority belong to the first, benign. The second degree grows faster and recurs more often, the third is rare and behaves aggressively. The exact degree is determined only after examining the removed tissue.
- Grade 1 - benign, slow growing, most cases
- Grade 2 - atypical, prone to relapse
- Grade 3 - anaplastic, rare and aggressive
- By location: convexital, parasagittal, skull base, wing of the sphenoid bone
- Meningiomas of the spinal canal
- Multiple meningiomas in neurofibromatosis type 2
Causes and risk factors
The exact reason is unknown. The tumor is more common in middle-aged and older women, which is associated with the influence of sex hormones: during pregnancy, meningiomas sometimes increase. Irradiation of the head, especially in childhood, significantly increases the risk. In people with the inherited condition neurofibromatosis type 2, meningiomas are multiple and occur early. Head injuries and the use of mobile phones have not been confirmed as a cause.
- Female gender, age over 40 years
- Radiation therapy to the head area in the past
- Neurofibromatosis type 2
- Hormonal influences, including pregnancy
- Obesity as a likely factor
Symptoms depending on location
Since the tumor grows slowly, the brain has time to adapt, and there are no complaints for a long time. When they appear, their character suggests location. A tumor on the convex surface of the hemisphere most often first manifests itself as a convulsive attack. Near the optic nerve - gradual deterioration of vision in one eye. At the base of the skull - double vision, numbness of half the face, decreased hearing. In the frontal region, changes in character, apathy and decreased criticism are possible, which loved ones sometimes mistake for depression.
- Seizures occurring for the first time in an adult
- Gradual decrease in vision, loss of visual fields
- Headache that gets worse in the morning
- Weakness or numbness in the limbs
- Behavioral changes, apathy, memory loss
- Double vision, facial numbness, hearing loss
- Gait and balance disorders
Diagnostics
The optimal method is MRI of the brain with intravenous contrast: meningioma looks like a clearly defined formation that intensively accumulates contrast and is associated with the membrane. CT is better at showing calcifications and changes in the adjacent bone. Vascular studies are sometimes needed to plan treatment. Additionally, vision is assessed by an ophthalmologist, an EEG is performed for seizures, and hormonal status is checked for tumors in the sella region. The final diagnosis and degree of malignancy is determined by the result of histological examination.
- MRI of the brain with contrast
- CT scan of the brain to evaluate bone and calcifications
- Electroencephalography for seizures
- Examination by an ophthalmologist with assessment of visual fields
- MRI of the spine with spinal localization
- Histological examination after removal
Treatment and observation
If the tumor is small, found by chance and does not cause symptoms, observation is often chosen: control MRIs at certain intervals to assess the rate of growth. In case of symptoms, significant size or confirmed growth, surgical removal remains the main method - the more completely the tumor is removed along with the affected membrane, the lower the risk of relapse. For difficult-to-reach or small tumors, stereotactic radiosurgery is used. For atypical and anaplastic forms, radiation therapy is usually performed after surgery. Convulsive syndrome is treated separately with antiepileptic drugs prescribed by a doctor.
- Observation with control MRI for asymptomatic findings
- Microsurgical removal for symptoms and growth
- Stereotactic radiosurgery for difficult-to-reach locations
- Radiation therapy for atypical and anaplastic forms
- Antiepileptic therapy for seizures
- Rehabilitation after surgery
- Long-term observation: relapse is possible even after years
