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Meningiomas

What are meningiomas?

Meningiomas are tumors in the meninges of the brain and spinal cord. Meninges are linings that cover the brain and spinal cord. Normally, the meninges serve as a wall between the blood and the brain and spinal cord. They prevent germs and other substances from entering the brain and spinal cord. Meningiomas are caused by the uncontrolled growth of abnormal cells. Most meningiomas are benign (noncancerous), but very rarely may be malignant (cancerous). They are most commonly seen in women, and in adults between 40 and 60 years of age. Diagnosing and treating meningiomas as soon as possible may relieve your symptoms and improve your quality of life.

What causes meningiomas?

The exact cause of meningiomas is still not known. The following may increase your risk of having a meningioma:

  • Diseases: Having breast cancer or other tumors increases your chance of having meningiomas.

  • Family history: Having a close family member with meningiomas, cancer, or neurofibromatosis type 2.

  • Genetic: You may have been born with genes that may cause meningiomas. A gene is a piece of DNA that tells your body what to do or what to make.

  • Hormones: Increased levels of female sex hormones, such as estrogen.

  • Skull fracture: Having a skull fracture may increase your risk of a meningioma. The skull is the bone of the head that protects the brain against injury. A skull fracture is a break in any of the bones of the skull.

  • Radiation: Radiation therapy used to treat a fungal infection of the scalp (skin covering the skull), or tumors of the head, neck, or brain. Atomic bomb survivors, such as those from Hiroshima, may also have an increased risk of meningioma.

What are the signs and symptoms of meningiomas?

The signs and symptoms of meningiomas are related to the size and location of the tumors. Signs and symptoms of meningiomas may be different depending on the part of the brain or spinal cord the tumors are pressing on. Meningiomas are slow growing, so people who have a meningioma may not know it and may not have any signs or symptoms. Those who do, may have any of the following:

  • Headaches, especially right after waking up.

  • Nausea (upset stomach) and vomiting (throwing up).

  • Paralysis (unable to move a part of the body) or problems moving the limbs, such as a leg.

  • Personality or behavior changes, such as depression and confusion (unclear thinking).

  • Problems with memory and mental function.

  • Problems with talking or seeing, such as reduced vision and blurred or double vision.

  • Seizures (convulsions).

How are meningiomas diagnosed?

Your caregiver will take your past and current health history. He may also want to know if other family members have had tumors or cancer. You may have any of the following:

  • Angiography: This test looks for problems with the arteries (blood vessels) supplying the meningioma. Before the x-ray, dye is put into a thin tube through a small cut in your groin. The groin is the area where your abdomen (stomach) meets your upper leg. The dye helps the arteries show up better on the x-ray pictures. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may also be allergic to this dye. Tell your caregiver if you are allergic to shellfish, dyes, or any medicines.

  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your skull and brain. You may be given dye, also called contrast, before the test. Tell the caregiver if you are allergic to dye, iodine, or seafood.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

  • X-rays: Plain x-rays of the head may show conditions or problems that will help your caregiver diagnose a meningioma.

How are meningiomas treated?

Treatment of meningiomas will depend on the location and size of the tumors, and the signs and symptoms you are having. You may need any of the following:

  • Watchful waiting: Watchful waiting may be all that is needed for meningiomas that are small and present in older people. Your caregiver may want you to have regular checkups and tests to see how your meningioma is doing.

  • Chemotherapy:

    • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

    • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

  • Endovascular embolization: Endovascular embolization is a procedure that may be done before surgery. During an angiogram, a special tube is inserted into your groin in a blood vessel that goes to your brain. When the artery that is supplying the meningioma is reached, a coil or glue is released. This creates an obstruction (blockage) that reduces or stops blood flow to the meningioma. This will help to decrease the size of the tumor and may help decrease blood loss during surgery.

  • Hormonal therapy: You may be given a hormone, called progesterone, for tumors that are not responding to surgery or radiation. These medicines may help shrink meningiomas that need estrogen for growth.

  • Radiotherapy: This is a treatment using x-rays or gamma rays. Radiation kills tumors and keeps the cancer from spreading. It also keeps tumor cells from dividing into new cells and growing, which is one way cancer spreads. Radiation may help decrease pain, control bleeding, and shrink the tumor.

  • Surgery: Surgical treatment for meningiomas may depend on the person's age, condition, and presence of other conditions, such as heart disease. The size, amount, and location of the tumors is also important. Your caregiver may open your skull to remove the tumor. He may also use a CT scan or MRI pictures to do frameless stereotaxy. Stereotaxy uses three-dimensional (3-D) pictures to help your caregiver know the exact location of the tumor. It also helps your caregiver guide special tools used during surgery. Ask your caregiver for more information about surgery for meningiomas.

Where can I find support and more information?

Having a meningioma is a life-changing disease for you and your family. Accepting that you have a meningioma is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who also have meningiomas. Contact the following for more information:

  • American Brain Tumor Association
    8550 West Bryn Mawr Avenue, Suite 550
    Chicago , IL 60631
    Phone: 1- 800 - 886-2282
    Web Address: http://www.abta.org
  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • National Brain Tumor Foundation
    22 Battery Street, Suite 612
    San Francisco , CA 94111-5520
    Phone: 1- 415 - 834-9970
    Phone: 1- 800 - 934-CURE
    Web Address: http://www.braintumor.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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