Meningiomas are benign tumours that arise from the linings of the brain (the meninges). There are no specific predisposing factors to these sorts of tumours. They can occur anywhere along the inner surface of the meninges, either within the brain cavity or within the spinal canal. The fact that they are benign means that they grow very slowly and as a result, patients will often have had these for many years before they are diagnosed with the tumour. A significant proportion of them can also stop growing.
The symptoms that they present with are a function of both their size and site. If a meningioma is growing in a part of the brain cavity adjacent to a relatively ineloquent part of the brain, it can cause fairly marked brain distortion without causing symptoms. In other more sensitive areas of the brain, meningiomas can create symptoms very early, either due to pressure on the brain or irritation of nerves exiting from the brain. As a consequence of this, there is no “typical” symptom arising from meningiomas. Due to their heterogeneous size and site, there is also no single treatment solution. The surgeons of the Brain and Spine Clinic would consider all of these factors including your medical history to formulate a very individualised treatment for your meningioma.
Very often, if you have a small meningioma with minimal or no symptoms (meningiomas are not infrequently diagnosed as incidental findings), the most sensible first management option would be to simply re-scan you to see whether indeed yours is a tumour that is actively growing or not. With growth rates of only 1 or 2 mm a year being typical, the initial interval before your first follow up scan is usually 6 months. This interval can be increased if the tumour remains stable on follow up scans and if this continues, no further active treatment may become necessary.
The management of your tumour will not only be discussed between you and your surgeon, but also at a Skull Base Multidisciplinary Team (MDT) Meeting. These are held fortnightly at Salford Royal Hospital, with a team of experts with a huge combined experience of managing such problems. Your surgeon will convey the outcome and recommendations of this meeting to you. Whilst this will provide you with all the information you require about your meningioma, as well as a detailed analysis of the advantages and disadvantages of all management options, the most important factor in the final decision is you. Your personal opinion of what is best for you is undoubtedly the most relevant aspect of how you will be managed.
The treatment of meningiomas is dealt with in greater detail in the meningiomas treatment page.