Meningioma: Non-Cancerous Tumors of the Brain and Spine

Non-cancerous, slow growing, tumors arising from the sheath covering the brain and spinal cord is called meningioma.

Introduction to Meningioma

Three layers of coverings wrap around the brain and the spinal cord. The outermost layer is the toughest and it is called the dura mater. The middle layer carries blood vessels and it is called the arachnoid mater. The inner most is a soft layer that is practically stuck to the brain and the spinal cord. It is called the pia mater.

A slow growing, mostly non-cancerous tumor, arising out of the arachnoid mater, is called a meningioma. They can form over the brain or the spinal cord. These tumors are soft, fleshy and rubbery to stony masses. They can crumble easily.

Meningiomas can occur without symptoms and they are rarely discovered. If meningioma without symptoms is discovered by chance, the patient is put under periodical observation. A patient is treated for meningioma only when it produces troublesome symptoms.

The following increase the risk of meningioma:

  • Radiation exposure
  • Dental X-Ray
  • Head injury
  • Excess body weight
  • Neurofibromatosis type-2 (about 50% of the patients with NF-2 develop meningioma)

About 8% of meningiomas can turn cancerous.

Complication due to Meningioma

If a growing meningioma starts to compress adjoining brain tissue or nerve fibers, it can cause complications ranging from severe pain to numbness to loss of control of various bodily functions.

About 8% of meningiomas can turn into cancerous tumor.

Symptoms of Meningioma

Symptoms of meningioma depend on the location and size of the tumor.

If the tumor arises in the sheath wrapping the brain, the following symptoms are seen:

  • Headache
  • Nausea
  • Vomiting
  • Seizures
  • Tremors
  • Gait problems
  • Speech disturbances

If the tumor occurs in the sheath wrapping the spinal cord, symptoms vary depending on the region of the spinal cord affected by the tumor. Common symptoms in these patients include:

  • Back pain, increased while lying down
  • Muscle weakness
  • Lack of sensation in one or more parts of the body
  • Difficulty moving arms and/legs
  • Thinning of the muscles of the hand
  • Hip pain
  • Pain radiating to the legs
  • Tingling or pricking sensation of legs
  • Gait problems
  • Loss of control over stools
  • Loss of bladder control
  • Impaired sexual functions
  • If the meningioma is sighted in the region of the nape, then the usual symptoms include headache, nausea and vomiting.

Diagnosis of Meningioma

The following imaging studies are useful in diagnosing a meningioma:

  • MRI

    MRI images are an excellent tool for diagnosing a meningioma. Even small tumors in early stage are seen in an MRI image.

  • MR Neurography

    MRN is used to visualize the nerves. When a meningioma is located in the sheath covering the spinal cord, an MRN is used to picture how the tumor is interacting with the nerves.

Treatment of Meningioma

Here are the treatment options available for meningiomas:

Medical Treatment

Medication can’t reduce the size of meningiomas. However, steroidal medications are used to reduce any fluid accumulation that is seen around the tumor. If the tumor happens to pinch on a nerve and cause pain, pain relievers may be used.

Surgical Treatment

Total Microsurgical Resection: The treatment of choice for meningioma is careful removal of tumor, without causing damage to the surrounding nerves, using tiny surgical instruments and microscopes. Go here for more information on Total Microsurgical Resection.

After surgery, in order to prevent recurrence of the tumor in the future, the surgery is followed by radiotherapy.

Treatment Window

Till such time a meningioma starts to grow rapidly, or it causes undue pain and discomfort, the patient doesn’t have to be worried. Otherwise, arranging for an immediate surgery is the most prudent thing to do.

Multiple Intracranial Aneurysms

Weak blood vessels in the brain tend to balloon at the points of their weakness. This is called an aneurysm.


Sometimes, weak blood vessels in the brain can bulge out like a balloon, causing a condition called aneurysm. When an aneurysm ruptures, it spills the blood it carries in to the brain, causing a life threatening condition.

About 1 in 50 people are thought to have an unruptured aneurysm. When an aneurysm ruptures, it can kill 40% of the people in whom the rupture occurs.

Causes of Aneurysm

Here are some common causes that lead to aneurysm:

  • High Blood Pressure

    The presence of high blood pressure weakens the blood vessel walls and make it vulnerable to bulging under any kind of stress or uncontrollable increase in blood pressure.

  • Smoking

    Smokers, particularly the ones who have been smoking for years, end up with their blood vessels weakening, making them susceptible for formation of aneurysm.

  • Blood Vessel Abnormalities

    When malformed blood vessels face any kind of internal stress, they can lead to formation of aneurysms.

  • Hereditary

    In some cases, aneurysm runs in the family. These patients are usually affected by aneurysm at a much younger age.

  • Congenital Disorders

    Some disorders that are present since birth are known to be associated with multiple brain aneurysms.

  • Gender

    When women hit menopause, the level of estrogen in their blood drops. This drop in estrogen makes them vulnerable for aneurysm.

Complication due to Aneurysm

The single most critical complication of aneurysm is rupture. Rupture of an aneurysm is dangerous to life. It can lead to irreversible brain damage and death.

Symptoms of Aneurysm

Small aneurysms rarely produce any symptoms. However, a large aneurysm may press upon important structures in the brain, causing symptoms like

  • Headache
  • Vision problems
  • Nausea
  • Weakness
  • Speech disturbance

If the aneurysm bursts, the patient may immediately fall unconscious and/or present with the following:

  • Sudden and severe headache
  • Sudden loss of vision
  • Sudden paralysis
  • Vomiting
  • Nausea
  • Stiffness of the neck
  • Seizures

Diagnosis of Aneurysm

These are the common tools used for diagnosing the presence of aneurysm

  • Angiography

    This is the best imaging modality for visualizing abnormally dialated blood vessels.

  • CT Imaging

    A CT Image plays an important role in localizing the site of rupture of an aneurysm.

  • MRI Imaging

    An MIR also helps to locate the exact site of aneurysm and to identify any bleed in the brain that occurs due to a ruptured aneurysm. Fluid accumulation in the brain can also be appreciated with the help of an MRI.

Treatment of the Aneurysm

Following are the treatment options available for aneurysm

Medical Treatment

There are no medical management options available for aneurysm. The best that can be done is to put the patient on pain relievers till they are surgically managed.

Surgical Treatment

There are two treatment choices available for aneurysm: Clipping and Coiling

Aneurysm Clipping

In this procedure, the skull is opened and the bulging blood vessel is identified. After identifying the vessel, the surgeon clips it just below the aneurysm, thereby preventing the aneurysm from rupturing.

Coiling of an Aneurysm

This is a minimally invasive procedure in which a catheter (tube) is into an artery at the groin. The tube is gently pushed forward till such time it reaches the blood vessel with the ballooning. At the site of the ballooning, a coil is inserted and the catheter is removed. Blood clot forms around the coil, which in turn heals the aneurysm.

Treatment Window

If an aneurysm is identified and the patient is symptomatic, immediate intervention is warranted so as to fix it before the aneurysm ruptures.

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