Meningiomas are the second most common intracranial tumor and the most common benign brain tumor. Only rarely are they malignant or behave in a malignant fashion. While they can occur in either sex and at any age, they most frequently are discovered in middle-aged women. Meningiomas may arise from any meningial surface; most arise intracranially and only rarely occur along the spine. Because they originate from the covering of the brain and spine (the dura), unlike gliomas that arise from within the neural tissue, symptoms occur as pressure is placed on the surface of the brain or spinal cord, Common locations include the convexity of the brain, the tuberculum sellae, the sphenoid ridge, the frontal region, and the posterior fossa. They arise from arachnoidal cap cells in the brain coverings (meninges).

Symptoms

Meningiomas may produce a variety of symptoms depending upon their location. Symptoms may include headache, double vision, loss of vision, personality changes, weakness of an arm or leg, or seizures to name a few. When located in the posterior fossa a person may experience numbness or pain in the face, loss of hearing, ringing in the ear, dizziness facial weakness, hoarseness of the voice, difficulty swallowing, neck pain and instability of the gait.

Treatment

•  Surgery: When a meningioma is of a significant size, which depends upon its location, or when symptoms are present, surgery is indicated. The surgical approach depends upon the location of the tumor. In many cases minimally invasive and endoscope assisted surgeries through the nose (extended endonasal approach) or through the eyebrow (supraorbital approach) can be undertaken. In all cases we attempt to design a surgery to have as minimal a cosmetic effect as possible.

•  Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT): In some cases the meningioma cannot be removed completely and some tumors regrow after a successful surgery. In these situations SRS using the Gamma Knife can frequently control tumor growth. This highly focused type of radiation is noninvasive and usually is given as a single outpatient treatment. Complications are rare.