Click to Enlarge

Meninges

A meningioma is a tumor that arises from the meninges — the membranes that surround your brain and spinal cord. The majority of meningioma cases are noncancerous (benign), though rarely a meningioma can be cancerous (malignant).

Meningiomas occur most commonly in women. Most people who develop a meningioma are adults. But a meningioma can occur at any age, including childhood.

A meningioma doesn't always require immediate treatment. A small meningioma that causes no significant signs and symptoms may be monitored over time for signs of growth. A meningioma that never grows may never require treatment.

Signs and symptoms of a meningioma typically begin gradually and may be very subtle at first. Signs and symptoms may include:

• Changes in vision, such as seeing double or blurriness
• Headaches that worsen with time
• Hearing loss
• Memory loss
• Seizures
• Weakness in your arms or legs

When to see a doctor
Most signs and symptoms of a meningioma evolve slowly. Make an appointment with your doctor if you have any persistent signs and symptoms that concern you.

If you have a sudden onset of seizures or sudden changes in your vision or memory, call your doctor right away or go to your local emergency room for evaluation.

Click to Enlarge

Meninges

Meningiomas occur in the cells that make up the meninges — the membranes that surround your brain and spinal cord, forming a protective barrier. It isn't clear what causes a meningioma to form.

Doctors know that something alters some cells in your meninges to make them multiply out of control, leading to a meningioma tumor. But whether this occurs because of genes you inherit, things you're exposed to in your environment or a combination of both remains unknown.

Risk factors for a meningioma include:

• Radiation treatment. Radiation therapy that involves radiation to the head may increase the risk of a meningioma.
• Female hormones. Meningiomas are more common in women, leading doctors to believe that female hormones may play a role.
• An inherited nervous system disorder. The rare disorder neurofibromatosis type 2 increases the risk of meningioma and other brain tumors.

A meningioma and its treatment, typically surgery and radiation therapy, can cause long-term complications, including:

• Difficulty concentrating
• Memory loss
• Personality changes
• Seizures

Your doctor can treat some complications and refer you to specialists to help you cope with other complications.

You're likely to start by first seeing your family doctor or a general practitioner. If your doctor suspects you may have a brain tumor, such as a meningioma, you may be referred to a specialist who treats brain disorders (neurologist).

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For a meningioma, some basic questions to ask your doctor include:

• Is my meningioma cancerous?
• How large is my meningioma?
• Is my meningioma growing? How quickly?
• What treatments do you recommend?
• What are the potential complications of each treatment?
• Are there long-term complications I should know about?
• Should I seek a second opinion? Can you recommend another doctor or hospital that has experience in treating meningiomas?
• Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?
• Do I need to make a decision about treatment right away? How long can I wait?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

Click to Enlarge

Meningioma

A meningioma may be detected on an imaging test, such as:

• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• X-ray

The treatment you receive for a meningioma depends on many factors, including the size of your meningioma, where it's located and how aggressive it's believed to be. Your doctor will also take into consideration your overall health and your goals for treatment.

No treatment
Immediate treatment isn't necessary for everyone with a meningioma. A small, slow-growing meningioma that isn't causing signs or symptoms may not require treatment.

If you choose not to undergo treatment for your meningioma, you'll likely have brain scans periodically to evaluate your meningioma and look for signs that it's growing. Your doctor creates a personalized follow-up schedule for you. For instance, you might undergo brain scans every few months at first and then have scans done annually. If at any time your doctor determines your meningioma is growing and needs to be treated, you have several treatment options.

Surgery
If your meningioma causes signs and symptoms or shows signs that it's growing, your doctor may recommend surgery. Surgeons work to remove the meningioma completely. But because a meningioma may occur near many delicate structures, such as your brain, eyes and spinal cord, it isn't always possible to remove the entire tumor. In those cases, surgeons remove as much of the meningioma as possible.

Surgery may carry a chance of significant risks, including infection and bleeding. The specific risks of your surgery will depend on where your meningioma is located. For instance, surgery to remove a meningioma that occurs around the optic nerve can lead to vision loss. Ask your surgeon about the specific risks of your surgery.

Radiation therapy
If your meningioma can't be completely removed, your doctor may recommend radiation therapy following surgery. The goal of radiation therapy is to destroy any remaining meningioma cells and reduce the chance that your meningioma may recur. Radiation therapy uses a large machine to aim high-powered energy beams at the tumor cells.

Radiosurgery
Radiosurgery is a specific type of radiation treatment that aims several beams of powerful radiation at a very precise point. Contrary to its name, radiosurgery doesn't involve scalpels or incisions. Radiosurgery may be an option for people with meningiomas that can't be removed with conventional surgery or for meningiomas that recur despite treatment.

No alternative medicine treatments have been found to treat meningiomas. But some forms of alternative medicine may be helpful in coping with the side effects of treatment and the stress of having a meningioma.

Alternative medicine therapies that may be helpful include:

• Acupuncture
• Hypnosis
• Massage
• Meditation
• Music therapy
• Relaxation exercises

Discuss options with your doctor.

Being diagnosed with a meningioma can be overwhelming. As you come to terms with your diagnosis, your life can be turned upside down with visits to doctors and surgeons as you prepare for your treatment. To help you cope, try to:

• Learn everything you can about meningiomas. Ask your health care team where you can get more information about meningioma and your treatment options. Visit your local library and ask a librarian to help you track down reliable resources for more information, including online sources. Write down your questions so that you'll remember to ask them at your next appointment with your doctor. The more you know about your condition, the better prepared you'll be to make decisions about your treatment.
• Build a support network. Having friends and family supporting you can be valuable. You may find it helps to have someone to talk to about your emotions. Other people who may provide support include social workers and psychologists — ask your doctor for a referral if you feel that you need someone else to talk to. Talk with your pastor, rabbi or other spiritual leader. Other people with meningiomas can offer a unique perspective, so consider joining a support group — whether it's in your community or online. Ask your health care team about brain tumor or meningioma support groups in your area, or contact the American Brain Tumor Association.
• Take care of yourself. Try to stay healthy during your treatment for a meningioma by taking care of yourself. Eat a diet rich in fruits and vegetables and get moderate exercise daily if your doctor allows it. Get enough sleep so that you wake feeling rested. Reduce stress in your life by focusing on what's important to you. These measures won't cure your meningioma, but they may help you feel better as you recover from surgery or help you to cope during radiation therapy.