Authored by Dr. Parth Jani, Consultant Neurosurgeon, M.Ch Neurosurgery (Gold Medalist),
HCG Hospital, Ahmedabad

The human brain, with its complex network of neurons and supporting structures, is protected by several layers of membranes that serve as a shield against external threats. These membranes, known as the meninges, are responsible for safeguarding the brain and spinal cord from injury and infection and play a role in maintaining a healthy central nervous system. Our lifestyle choices, such as stress levels, diet, and physical activity, can impact the health of these critical membranes. When the balance is disrupted, it can sometimes lead to complications. One such issue occurs when abnormal growths develop within these protective layers, resulting in meningiomas.

Meningiomas are typically slow-growing tumors originating in the meninges, and while many are benign, they can still cause significant health issues depending on their location and size. While the precise cause of meningiomas is not always clear, certain risk factors such as prior radiation exposure or genetic predisposition may contribute to their development. Due to their potential to impact neurological function, early detection and a comprehensive approach to treatment are critical to reducing complications and improving the quality of life for those affected.

Commonly known characteristics of Meningiomas

Though meningiomas can form anywhere along the meninges, they typically do so in the vicinity of the base of the skull and the convexities, or exterior surfaces, of the brain. Some stay dormant for years while others grow more quickly; their rates of growth differ. When a tumor grows, symptoms could start mildly and get worse over time. They may consist of:

• Vision abnormalities, such as blurring or double vision
• Severe Morning headaches
• Ear ringing or loss of hearing
• Loss of memory
• Loss of smell
• Seizures
• Speaking difficulties

Diagnosis of Meningiomas:

Meningiomas tend to grow slowly, which can make them difficult to diagnose. Their symptoms are often mild and can be easily confused with other medical conditions or even typical signs of aging. To accurately identify a meningioma, neurologists usually perform a comprehensive neurological examination along with contrast-enhanced imaging tests, such as the following:

1. Imaging Techniques: Magnetic resonance imaging (MRI) and computed tomography (CT) scans can provide detailed images of the brain and help identify the size, location, and characteristics of the meningioma.
2. Biopsy: In some cases, a tissue sample may be obtained through a surgical procedure to confirm the diagnosis and determine the grade of the tumor.

• Genetic Testing: Genetic testing may be recommended to identify specific genetic mutations associated with meningiomas, such as NF2 (neurofibromatosis type 2).

Treatment Options for Meningiomas:

The treatment approach for meningiomas depends on several factors, including the size, location, and grade of the tumor along with the symptoms. An individual’s overall health can also influence the treatment options. However, here are a few treatment options that are commonly considered:

1. Observation: Small, asymptomatic meningiomas may be closely monitored with regular imaging studies and periodic clinical evaluations. This approach allows you to avoid the potential risks of surgery or radiation therapy if the meningioma isn’t causing problems.
2. Surgery: Surgical removal is often the primary treatment for meningiomas when feasible. The goal is to remove the tumor while preserving neurological function. When possible, minimally invasive procedures like endoscopic surgery are chosen since they leave fewer scars and have faster recovery times.

• Radiation Therapy: High-energy X-rays or other radiation treatments are used in radiation therapy to target tumors, reduce their size, or stop them from growing. For incurable cancers, it can be utilized to eradicate any leftover tumor cells following surgery.

1. Medications: In cases where surgery or radiation therapy is not possible or sufficient, medications such as somatostatin analogs or targeted therapies may be utilized to control tumor growth or manage symptoms.

Meningiomas represent a complex category of brain tumors that demand thorough evaluation and customized treatment plans. To manage this condition and make informed choices, it’s crucial to understand the symptoms, diagnosis process, and potential treatment options. Increasing awareness and encouraging early detection can lead to better outcomes, improved quality of life, and greater support for those dealing with meningiomas. By focusing on education and timely intervention, we can offer hope and more effective care to those affected by this illness.