Meningioma brain tumours
Surgery is the main treatment strategy.
Find out more about meningiomas, or a type of primary brain tumours
Neurosurgeon Brisbane
Meningioma brain tumours key points
- Meningiomas are one of the most common primary brain tumours and they come in 3 grades: grade 1 is the most benign form and grade 3 is the cancerous form.
- Fortunately, most meningiomas are benign.
- Surgery is the main treatment strategy because meningiomas cause problems by physically pressing on parts of the brain and irritating it.
Meningioma | Brain tumour surgery Brisbane
What is it?
Meningiomas are one of the most common brain tumours that neurosurgeons see and treat. These tumours actually don’t grow from brain tissue itself, but rather from the lining of the brain.
The brain has 3 layers surrounding it. Meningiomas arise from the middle layer called the arachnoid (called arachnoid because under very high magnification it does indeed look like a spider’s web).
Meningiomas come in 3 grades:
- Grade 1 is the most benign form and grade 3 is the cancerous form.
- Fortunately, grade 1 is by far the most common.
- It is so common yet so benign that there are actually many people who live normal lives and die never having known that they actually had a meningioma.
It is very common for neurosurgeons to see and treat them, but very uncommon for non-medical people to hear about them.
Meningioma symptoms
What are the symptoms?
There are only 3 symptoms that can occur:
- Headaches due to pressure on the brain from the tumour pushing on the brain and causing swelling in the brain. This pressure can also make you feel vague and somewhat confused.
- Stroke-like symptoms such as speech issues, vision problems and weaknesses in your arms, legs or face. For example, if the tumour is pressing on the speech centre of the brain then you might have problems speaking. If it is pushing on the movement part of your brain then you may have weakness in your face, arms or legs. Similarly, if it is in the vision part of your brain then you may have blind spots in your vision, and keep running into things.
- Seizures: There are different types of brain tumours that are more likely to cause seizures, however occasionally meningiomas can cause a seizure. It is very rare for this to lead to an epilepsy problem long term.
Benign meningioma
Is it dangerous?
Most meningiomas are benign, meaning they do not transform into cancer and do not spread to other parts of the body. The way meningiomas cause problems is by slowly squashing parts of the brain as they gradually grow over time. They can cause either symptoms like headache, stroke-like symptoms from pressing on important parts of the brain or seizures. This is obviously dangerous and when you are experiencing these symptoms you will need treatment.
Grade 2 and grade 3 meningiomas are more dangerous because they grow more quickly and can spread further along the lining of the brain. Occasionally they can actually invade the underlying brain. Grade 2 and 3 meningiomas always need treatment.
Neurosurgeon Brisbane
There is only one risk factor that we are aware of and that’s excessive radiation. This used to be an issue many years ago when children were given whole brain radiotherapy for childhood brain cancers. Fortunately this type of treatment does not occur anymore.
Radiation from flying on a plane or from a mobile phone is nowhere near strong enough and does not cause meningiomas. I have spent my entire life on my mobile phone taking emergency calls and I am not worried about getting a brain tumour.
Almost all meningiomas are not inherited, meaning you didn’t get a bad gene from your parents and you can’t pass a bad gene to your children that will cause meningiomas.
There is one genetic condition that does cause meningiomas and this is NF 2. This is exceptionally rare.
Meningiomas only affect the lining of the brain and the lining of the spinal cord (because it is all one continuous lining). They do not affect any other part of the body.
Meningioma treatment
How is it treated?
Surgery is the main treatment strategy. This is because meningiomas cause problems by physically pressing on parts of the brain and irritating it. The only way to deal with that problem is to surgically remove the meningioma.
For some meningiomas that are too risky to be removed by surgery, they can be treated with radiotherapy. The technology for radiotherapy in modern times is very good and little, if any, of your normal brain gets affected by the precise and accurate machines that deliver the radiotherapy.
Do I need surgery when I have a meningioma?
When I see you and examine you and your scans I will be able to determine whether you need surgery or not. It is more complicated than this but this is certainly the jist of it.
There are 3 reasons that you might need surgery when you have a meningioma:
- To get a diagnosis.
Almost always I can tell if something is a meningioma from looking at your scan. What I can’t be so sure about is what grade it is. One way is to watch it with serial scans over time. If the tumour does not change then it is almost certainly a grade 1. If it does change then it could be anything from a grade 1 to a grade 3 and surgery is required to get a specimen. This specimen gets sent to the laboratory where they can do a series of tests on it and get the answer once and for all. - To relieve symptoms of pressure.
By reducing the size of the tumour it is possible to significantly improve your symptoms like headache. If the tumour is causing stroke-like symptoms then it may also be possible to improve this by removing as much of the tumour as it is safe to do so. So this is all about improving your quality of life. - Oncological.
Often by removing all of the tumour you can be cured of the tumour. This is a very good reason to have surgery.
Treatment is very effective for grade 1 meningioma. Grade 2 and grade 3 can require a lot more treatment to get control of it. It is quite complicated but I can take you through all of this.
Recovery from surgery to remove a meningioma depends on the type of surgery performed. Most of the time recovery is about 2 weeks to feel more normal again. I will give you a better idea once I have seen you and your scan.
It is vital that you are in control as much as possible, and that includes knowing everything you can going into treatment. I will take you through this and all the risks and benefits of treatment.
Here are the main risks of surgery for brain tumours:
- Risk of stroke
- Risk of epilepsy
- Bleeding needing a second operation to remove the blood clot
- Infection requiring antibiotics or a second operation to washout the infection
- Risk that the tumour cannot be removed completely. Sometimes tumours are deliberately left behind so that you are not put at risk of stroke.
Fortunately with modern technology and equipment the risks are significantly less than what they used to be 20 or even 10 years ago.
Neurosurgery has come a long way in modern times. Now surgery can be done quite routinely and with relatively quick recovery. Remember, most of the time we are trying to improve your quality of life by removing the tumour so performing an operation that makes you no better, or even worse is not appropriate. Performing big surgery to remove everything at all costs (to you) is certainly not a modern way of thinking. I will take you through everything when I see you and explain how I will get you through this as good as possible.
Neurosurgeon Brisbane
Dr Alex Koefman, Neurosurgeon Brisbane
What if I just leave it? Can I just rest it?
Interestly, I can manage many meningiomas without doing surgery, just by watching them with serial scans. There are many factors to consider here though. I would need to see you and your scans to work out if this is right for you by taking everything into account.
Modern neurosurgery has a philosophy of performing the most effective surgery possible without doing any harm to you and your brain. This is something I take very seriously. I spend a lot of time considering all the factors and planning the best way to get you back to your normal life without putting you at unacceptable risk.
Brain surgeon Brisbane
What should I do now?
If you have a brain tumour, and would like modern treatment with me, then please contact my team here as soon as you can.
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Ramsay Specialist Centre
Suite 325
Newdegate St
Greenslopes QLD 4120
