Meningioma: Symptoms and Treatment
Meningioma is a tumor that forms in the region of the spinal cord or brain from spider webs (arachnoid). It can be either globular or horseshoe-shaped, and very often it connects to the hard shells of the spinal cord or brain, and the focus of growth in it is predominantly not one but several.
In most cases, the tumor is benign, in the same cases when it is malignant, its aggressive growth provoking severe symptoms is noted, and frequent recurrence after removal. However, any neoplasms located in the brain area are considered by doctors to be «conditionally malignant,» as they develop symptoms of compression of the brain substance that worsen the prognosis of the course of the disease. And although such a tumor grows slowly, it often has such a localization that does not allow to completely remove it, which worsens the prognosis.
This tumor is twice as likely in women, rather than in the strong half of humanity. And children rarely get sick — the age of people from 40 to 70 is the most pathologically affected. The tumor is localized in various parts of the spinal cord or brain. The primary locations for localization are:
- large hemispheres
- Tentorial clipping
- large occipital foramen;
- wedge-shaped wings
- cavernous sinus
- the area of the olfactory fossa
- parasagittal sinus and other areas.
As the tumor grows slowly and does not tend to malignancy, it happens that for a very long time its symptoms are absent, and doctors can detect pathology only as a result of an accidental examination of the patient by magnetic resonance imaging or computed tomography (for any other diseases ). In some cases, the tumor generally stops in growth and then it does not require treatment — the doctor should regularly observe the patient, if there are no symptoms of the disease and the growth does not increase in size. However, if the disorders caused by compression of the brain substance by the neoplasm have already appeared, it is by no means impossible to ignore them.
Note that the meningioma of the spine is extremely rare, grows slowly and in the initial stages also occurs asymptomatically. However, its excessive growth can provoke compression of nerve endings, with the onset of paralysis and paresis, so treatment of such a tumor should be timely, and it consists in removing the tumor.
One of the common forms of pathology is the meningioma of the optic nerve. For a very long time scientists have argued whether such a tumor can be primary, or it is secondary, as a result of the germination of the tumor into orbit. Today it is established that the meningioma of the optic nerve is also primary, that is, when the tumor is formed directly in the orbit, and secondary.
Neoplasm of this character in the region of the brain or spinal cord has no studied causes. Researchers have not been able to establish in what cases a tumor can appear accurately, but the risk factors have been studied. These factors include:
- Female gender and age over 40;
- Some genetic pathologies, for example, neurofibromatosis of the second type
- ionizing radiation (it was formerly believed that high doses of radiation can cause brain formation in the brain, but recent studies have proven that dangerous radiation for developing a tumor such as meningioma is low radioactive radiation.)
It also indicates the causes of the disease, such as a history of breast cancer or sarcoma, as part of the Lee-Fraumeni syndrome. In addition, the causes are also in genetic abnormalities — according to studies, there is a correlation between such a neoplasm and the defect of chromosome 22.
The reasons for the active growth of the tumor can be the hormonal changes in the body of a woman. For example, it can occur during pregnancy.
Tumors of the brain or spinal cord that have arisen in the arachnoid shell are classified according to their location. In most cases (40-50%), they are convective, that is located in the main zones of the brain (parietal, frontal, occipital). In 20-30% of cases — parasagital (falx-meningioma, tumor of the superior sagittal sinus of the crescent process). The tumor, located in the area of the olfactory fossa, refers specifically to this form of meningitis, and it is rare. And in 20-30% of cases such neoplasms grow on the basis of the skull and are called basal.
There is also a classification according to the severity level, according to which the following are distinguished:
- atypical meningiomas
The most favorable prognosis in a benign neoplasm. As mentioned above, it grows slowly, and often stops at all in growth, and then treatment is not carried out, but observation is carried out. But even if the tumor grows slowly and its removal is shown, the frequency of relapses is extremely small, so the prognosis for the patient’s life is favorable. Such a neoformation can be of nine different forms — depending on the structural structure.
Atypical form is also a benign meningioma, but unlike benign, it grows rapidly, which leads to compression of the brain substance and the appearance of symptoms of brain damage. Malignant tumor is more common in men than in women. It is characterized by rapid growth and a high probability of relapses, so the prognosis for such pathology is extremely unfavorable, especially considering that a neoplasm is detected at the stage of development of metastasis.
In addition, with malignant neoplasm of the spinal cord and the brain, nearby tissues and organs are involved in the process, so the complete removal of such a tumor is impossible, which increases the risk of relapse.
In cases where the meningioma is small, its symptoms may be absent. With the growth of the tumor, there are focal and general cerebral symptoms of the pathology, which include:
- hearing problems
- nausea and vomiting on a background of well-being
- smelling impairment
- epileptic seizures
- impaired consciousness.
If the patient has a meningioma of the optic nerve, he may be disturbed by the following symptoms:
- appearance of vision changes characterized by worsening peripheral vision, with a gradual fall in central vision
- headaches and pains in the orbit of the eye from the affected side
- exophthalmos and limitation of eye mobility
With the development of the process, the meningioma of the optic nerve leads to persistent visual impairment due to the atrophy of the optic nerve disc. Focal symptoms of the pathological state depend on the location of the tumor. So, if it is located in the cerebral hemispheres, on the surface, convulsions may occur. Also in this case, hyperostosis of the bones of the skull develops. A distinctive symptom that has the meningioma of the optic nerve from the brain forms of pathology is precisely the absence of bone hyperostosis.
With the location in the frontal lobe, weakness in the limbs, numbness. The defeat of the posterior cranial fossa causes the uncoordinated movements and changes in gait. Also, when the meningioma is located in the region of the posterior cranial fossa, auditory disorders may develop. The main symptoms of pathology at this or that location of the tumor are known to neuropathologists, so timely diagnosis will avoid complications and improve the prognosis of the pathology.
Diagnosis and treatment
Diagnosis of the disease usually presents no difficulties, but only if the symptoms of the tumor have already manifested itself. To confirm the diagnosis, CT and MRI, as well as PET, selective and nonselective angiography and scintigraphy are shown.
Also patients are sent for consultation to such doctors as:
- Eye doctor
- The otolaryngologist
As already mentioned above, the treatment of meningioma is primarily surgical and consists in the removal of the tumor. But, in addition, this disease requires the use of radiation therapy. Radiation therapy is necessary, first, because a part of the tumor can not be removed during the operation, and it is destroyed with it. And, secondly, it is required in order to avoid relapses.
If the tumor is located in the area of the spinal cord or brain superficially, the prognosis after its removal is extremely favorable. A slightly worse prognosis is when it affects neighboring tissues and sprouts into neighboring organs. And unfavorable is the prognosis for aggressive malignant meningioma — fortunately, only 1% of all meningiomas are such cases.