A meningioma is in most cases a benign brain tumor that initially causes no symptoms due to its slow growth. Meningiomas are among the most common brain tumors, accounting for around 15 percent of all tumors inside the skull, with women developing meningioma more frequently than men.
What is a meningioma?
A meningioma is usually a benign (non-cancerous) and slow-growing brain tumor that starts from the so-called meninges, the covering cells of the arachnoids of the brain and spinal cord, which, together with the pia mater as soft meninges (leptomeninx), form the cranial cavity below the lining the hard meninges. See AbbreviationFinder for abbreviations related to Meningioma.
Meningiomas usually border the dura mater from the inside and displace the surrounding tissue as they grow, which can cause damage to the meninges and neurological disorders. A meningioma can have several tumor foci (meningiomatosis) as well as diffuse (scattered) growth, whereby those affected with more than one tumor foci usually have a genetic disease ( neurofibromatosis type 2 or Recklinghausen’s disease).
The causes of the development of a meningioma have not yet been fully clarified. It is considered certain that a meningioma develops when arachnoid cells or cells of the cobweb skin degenerate and proliferate, although the triggers for this degeneration process are unclear.
In addition, children who have been exposed to radiation therapy as a result of a tumor disease have an increased risk of developing meningiomas, especially malignant ones.
Genetic factors are also assumed, since in many cases a loss of information on chromosome 22 can be determined in those affected by meningiomas.
However, a craniocerebral trauma or a meningeal tumor as well as other skull injuries can be ruled out as triggering factors for a meningioma.
Symptoms, Ailments & Signs
A meningioma often exists for several years before the first symptoms appear. The first signs of a brain tumor are non-specific and can occur in different parts of the body. For example, odor disorders, visual and speech disorders, exhaustion, headaches and paralysis of the limbs can occur. Seizures, loss of arms and legs, and mental changes can also occur.
If the tumor is localized in the spinal canal, abnormal sensations, back pain and nerve problems occur. Externally, a meningioma can be recognized by weight loss, pale skin, and a generally sickly appearance. The meningioma develops very slowly and the brain can adapt well to the tumor, which is why those affected usually do not notice any signs of the disease themselves.
It is often the relatives who notice noticeable symptoms such as personality changes. Older patients then show signs of dementia or depression, while children and adolescents may experience growth disorders. If the tumor is localized in the bony skullcap, this can lead to increased bone growth. The result is an externally visible bump.
In some patients, the eyeball also protrudes. This so-called exophthalmos is also associated with pain and severe discomfort. Symptoms increase as the tumor grows and resolves slowly after the growth is removed. Long-term damage often remains.
Diagnosis & History
Imaging diagnostic methods such as CT (computed tomography) or MRI (magnetic resonance imaging) are primarily used to diagnose a meningioma . Here, the tumor is made visible using a contrast medium with which it is enriched.
If a tumor with a smooth border in the area of the meninges and the characteristic thickening in the contact area between the tumor and the meninges are found during these procedures, a meningioma can be assumed.
A meningioma usually progresses well, but in rare cases (1.7 percent) it can degenerate into a malignant brain tumor with metastasis. Due to the very slow growth of this type of brain tumor, a meningioma often causes no symptoms initially and is diagnosed accidentally years later.
If symptoms such as neurological disorders (paraesthesia, restricted vision or speech) occur, a surgical intervention is required. In some cases (13 percent), with so-called anaplastic or atypical meningiomas, the prognosis is less favorable.
In most cases, a meningioma is diagnosed late because it does not lead to any particular symptoms or complications during the first months and years as it grows. For this reason, early treatment of this disease is usually not possible. Those affected primarily suffer from severe headaches and sensory disturbances.
Sensitivity disorders and paralysis in various regions of the body also occur. Due to the paralysis and restricted movement, those affected may be dependent on the help of other people in their everyday life. It is also not uncommon for epileptic seizures and visual disturbances to occur.
Patients also suffer from thinking and speech disorders, so communication with other people is also made difficult by the meningioma. The quality of life is significantly reduced by this tumor. The tumor can be removed by surgery.
It cannot be generally predicted whether the symptoms will disappear completely. As a rule, those affected are then also dependent on chemotherapy, which often leads to various side effects. The life expectancy of the patient can also be reduced by the meningioma.
When should you go to the doctor?
Diagnosing a meningioma is often difficult because the ulcer grows very slowly. The signs and symptoms can thus be mistaken for other disease states or written off as normal signs of aging. Headaches that are only temporary can be eliminated by changing your diet or drinking more water. The conscious avoidance of psychological stress and more sleep can also provide a significant relief.
The workplace in the office should possibly be optimized, as mismatches between screen orientation and sitting position can also have a negative effect on the head joints, which can lead to headaches. A physical therapist or osteopath can help with this. A visit to the family doctor is appropriate for persistent headaches that get progressively worse over time. If he suspects a meningioma, he may be referred to a neurologist, who will then carry out examinations followed by imaging tests such as CT or MRI.
Sometimes a meningioma may require emergency care if there are sudden onset seizures, changes in vision, or changes in memory.
Treatment & Therapy
The therapy for a meningioma depends on the location, size and rate of growth of the tumour. Due to the basically benign character and the very slow growth of a meningioma, its development is observed at the beginning in the course of follow-up examinations.
If neurological disorders manifest themselves, the meningioma is surgically removed. Angiography is used to visualize the meningeal arteries that supply the meningioma, which are embolized (obliterated or closed) during the procedure to minimize blood loss. Surgical intervention aims at complete removal of the meningioma.
If complete removal of the tumor is not possible or if a malignant meningioma is present, additional radiation therapy is required after the operation to kill the residual tumor cells. Small tumors (maximum three centimeters in diameter) are irradiated once with a gamma knife or linear accelerator with high doses of gamma rays as part of radiosurgery. This form of therapy is also used when the meningioma is in an unfavorable position for surgery or the general condition of the person concerned does not allow such an intervention.
Chemotherapy is only used in exceptional cases for a meningioma, since there have only been a few clinical or experimental studies on this and its effectiveness in meningioma has not yet been proven.
Outlook & Forecast
Statistically, six out of 100,000 people will develop a meningioma in their lifetime. A striking number of patients are between 40 and 60 years of age at the time of diagnosis. There is a higher risk for women. If one looks at the chances of recovery, the picture is mixed. About nine out of ten diseases are benign. If such a tumor can be completely removed even through surgery, a full recovery is likely. If, on the other hand, tumor cells remain, they will grow again.
In one out of ten other cases, the meningioma is fast-growing or malignant. This tumor has a comparatively poor prognosis. On the one hand, there is an increased risk of renewed growth. On the other hand, with the malignant form, metastases form in every third patient. Almost 80 percent experience renewed tumor growth within five years of the prognosis when they last trained.
The position of the tumor tissue always plays a role in evaluating the prospect. For example, if it is attached to the underside of the brain, it usually cannot be completely removed. Also, in such an unfavorable position, a surgeon can easily damage the brain. This creates permanent, irreparable neurological disorders.
Since the triggering factors for the manifestation and development of a meningioma have not yet been clarified, it cannot be prevented. In general, unnecessary radiation (especially in children) and carcinogenic substances such as nicotine or alcohol should be avoided. In addition, a healthy diet and physical activity strengthen the body’s defense system and help minimize the risk of cancer and thus the risk of meningioma.
Meningioma is very often diagnosed relatively late, since there are hardly any symptoms or complications in the first years or months of growth. Therefore, it is hardly possible to treat this disease early. The patients mainly suffer from sensory disturbances and severe headaches, but there can also be signs of paralysis in different parts of the body.
As a result, those affected can be restricted in their movement and then also need help to be able to cope with their everyday life. Visual disturbances or epileptic seizures can also occur. Patients often also suffer from speech or thinking disorders, which can lead to problems in communication. The quality of life of patients can therefore suffer considerably when a meningioma occurs.
The tumor can be removed by surgery, but it cannot be predicted with certainty whether the symptoms will go away completely. Normally, patients also have to undergo chemotherapy, which can cause a wide variety of side effects. In addition, the life expectancy of those affected by a meningioma can be reduced because the risk of the tumor growing again is relatively high.
You can do that yourself
In addition to medical treatment, meningioma patients can resort to a number of strategies and self-help measures to make everyday life easier and to support therapy.
First, the doctor will recommend rest and rest. Especially in the first time after an operation, the affected person has to avoid strenuous activities. A balanced diet in which fiber is consumed instead of carbohydrates is also recommended. Since brain tumors need sugar to grow, you should also avoid sweet foods, certain types of fruit and sweetened drinks such as lemonade or cola. Foods like chickpeas, soybeans, and red clover should be included in the diet because of their high content of biochanin — a fiber that has a healing effect on tumor cells. In addition to a change in diet, general measures such as regular exercise and avoiding stress are recommended.
Affected people are also recommended to visit a self-help group and exchange ideas with other affected people. In general, it is important to understand the disease, because this is the only way to overcome it emotionally in the long term. The German Brain Tumor Aid Association offers further information for those affected.