intracranial meningioma

Intracranial Meningioma: A Benign Brain Tumor

An intracranial meningioma is a type of tumor that forms in the meninges, which are the layers of tissue that cover and protect the brain and spinal cord. According to [3], a meningioma is a tumor that originates from arachnoid cap cells, which are cells within the thin, spider web-like tissue that surrounds the brain.

Types of Meningiomas

There are different types of meningiomas, including olfactory groove meningioma, which forms along the nerves that run between the brain and the nose [2]. This type of tumor accounts for around 10 percent of meningiomas. Intraventricular meningiomas arise from chambers of cerebrospinal fluid, which can block the flow of this fluid in the brain and spine [7].

Symptoms

The symptoms of an intracranial meningioma can vary depending on the location and size of the tumor. Common symptoms include: * Vision loss or double vision [1] * Headache that worsens with time [6] * Hearing loss or ringing in the ears [6] * Memory problems * Difficulty swallowing * Seizure

Prevalence

Meningiomas are the most common benign intracranial tumor, and they are more often seen in women [8]. According to [5], meningiomas are a primary central nervous system (CNS) tumor that begins in the brain or spinal cord.

Diagnosis

A diagnosis of meningioma is typically made using imaging tests such as MRI scans or CT scans. A biopsy may also be performed to confirm the presence of a meningioma [9].

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Common Signs and Symptoms of Intracranial Meningioma

Intracranial meningiomas can cause a wide range of symptoms, depending on their location and size. Here are some common signs and symptoms:

• Headaches: Headaches are one of the most common symptoms of meningioma, ranging from mild to severe (3, 4).
• Seizures: Seizures can occur due to compression of the brain by the tumor (2, 6).
• Weakness or numbness: Weakness or numbness in the arms or legs can be a symptom of meningioma, especially if it is located near the spinal cord (3, 4).
• Vision loss: Compression of the optic nerve or other visual pathways can lead to vision loss (4).
• Memory and concentration problems: Difficulty concentrating and memory loss are also possible symptoms (2, 6).
• Personality changes: Some people may experience personality changes, such as mood swings or depression (2).
• Language difficulties: Language difficulties, including speech problems, can occur if the tumor is located near language centers in the brain (2).

Other Possible Symptoms

In addition to these common symptoms, meningiomas can also cause other problems, such as:

• Dizziness and balance problems
• Tinnitus or hearing loss
• Loss of smell
• Mental changes, including confusion and disorientation

It's essential to seek medical attention if you experience any of these symptoms, as early diagnosis and treatment can improve outcomes.

References: [1] [2] [3] [4] [5] [6]

Diagnosing Intracranial Meningiomas: A Comprehensive Overview

Intracranial meningiomas are typically diagnosed using a combination of physical examination findings and imaging tests. Here's an overview of the diagnostic tests used to diagnose these tumors:

• Imaging Tests: Imaging tests play a crucial role in diagnosing intracranial meningiomas. The most commonly used imaging tests include:
  • Brain MRI (Magnetic Resonance Imaging): A brain MRI scan with contrast is considered the best imaging test for diagnosing meningioma [3]. It provides detailed images of the brain and helps identify the tumor.
  • Computed Tomography (CT) Scan: CT scans take X-rays that make cross-sectional images of a full picture of the brain. They are often used in conjunction with MRI to confirm the diagnosis [11].
• Physical Examination: A thorough physical examination is also essential for diagnosing intracranial meningiomas. This includes:
  • Neurological Exam: A neurological exam is performed by a neurologist to assess changes in vision, hearing, balance, coordination, and other neurological functions [2].
  • Vision and Hearing Tests: Detailed vision and hearing tests may be ordered to identify any abnormalities [4].

Additional Diagnostic Tools

Other diagnostic tools that may be used to diagnose intracranial meningiomas include:

• Positron Emission Tomography (PET) Scan: A PET scan uses a small amount of radioactive material to create detailed images of the brain and help identify the tumor [8].
• Chest X-ray: A chest x-ray may be ordered to rule out any metastasis or other conditions that may be causing symptoms [9].

Molecular Diagnostics

The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. Molecular diagnostics can help identify specific genetic mutations and provide more accurate diagnoses [14].

Conclusion

Intracranial meningiomas are typically diagnosed using a combination of imaging tests, physical examination findings, and other diagnostic tools. A thorough diagnosis is essential for developing an effective treatment plan.

References:

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Treatment Options for Intracranial Meningiomas

Intracranial meningiomas are typically benign (noncancerous) tumors that can be treated with various methods, including surgery, medication, and radiation therapy. While the primary treatment for most meningiomas is surgical resection, drug treatment may also be considered in certain cases.

Medication Therapy

Medication therapy, also known as chemotherapy, is rarely used to treat meningiomas [2]. However, it may be employed when the tumor does not respond to surgery or radiation therapy. The main drugs studied for treating meningiomas include:

• Temozolomide: This medication had no effect against recurrent meningiomas in a phase 2 study [3].
• Hydroxyurea: This drug was used in combination with imatinib for recurrent refractory meningiomas, but the treatment did not affect tumor growth [4].

Targeted Therapy

A new study has identified a drug that inhibits the growth of aggressive meningiomas and provides insights into how to accurately identify which tumors will respond to this medication [9]. This targeted therapy approach may offer a promising treatment option for patients with meningiomas.

Other Treatment Options

In addition to surgery, radiation therapy, and medication therapy, other treatment options are being explored. These include:

• Sandostatin: A long-acting release drug that can help address recurrent tumors by targeting specific receptors on the abnormal cell surfaces [6].
• Corticosteroids: Such as dexamethasone, which may be used to reduce tumor size and alleviate symptoms [8].

Conclusion

While surgery remains the primary treatment for most meningiomas, medication therapy and targeted therapy are being explored as potential treatment options. Further research is needed to determine the efficacy of these approaches and to identify the best course of treatment for individual patients.

References:

[1] A Shahbandi (2023) - Complete surgical resection or radiotherapy are effective treatments for WHO grade I meningiomas, with an excellent prognosis with complete resection [2, 3].

[2] Mar 29, 2024 - Medicine therapy, also called chemotherapy, rarely is used to treat meningiomas. But it may be used when the meningioma doesn't respond to surgery or radiation therapy.

[3] Oct 5, 2022 - The main drugs studied include temozolomide, which had no effect against recurrent meningiomas in a phase 2 study, and hydroxyurea (...

[4] by F Nigim · 2018 · Cited by 45 — Hydroxyurea and imatinib were used for recurrent refractory meningiomas, and while the treatment was well tolerated, the combination treatment did not affect tumor growth.

[5] Since the vast majority of meningiomas are benign (noncancerous), they are most commonly treated with surgery. Total removal of a meningioma is preferred since...

[6] Sandostatin, a long-acting release drug that can help address recurrent tumors by targeting specific receptors on the abnormal cell surfaces; also produces very...

[7] Aug 26, 2024 — Drugs Approved for Brain Tumors · Afinitor (Everolimus) · Afinitor Disperz (Everolimus) · Alymsys (Bevacizumab) · Avastin (Bevacizumab) · Belzutifan...

[8] Oct 5, 2022 — Medication Summary · Corticosteroids · Class Summary · Dexamethasone (Decadron, Dexasone).

[9] A new study has identified a drug that inhibits growth of aggressive meningiomas and how to most accurately identify which tumors will respond to the drug.

Differential Diagnosis of Intracranial Meningioma

Intracranial meningiomas are typically benign tumors arising from the meninges, but their differential diagnosis can be challenging due to overlapping clinical and radiological features with other pathologies. Here are some key points to consider:

• Schwannomas: These are the most common differential diagnoses for intracranial meningiomas [4]. Schwannomas arise from the nerve sheaths and can present with similar symptoms, such as hearing loss, tinnitus, and facial weakness.
• Other rare meningeal tumors: Solitary fibrous tumor/hemangiopericytoma (SFT/HP) is another differential diagnosis to consider [4]. These tumors are rare and can mimic meningiomas in their presentation.
• Inflammatory, infectious, and vascular lesions: These types of lesions can also present with similar symptoms and radiological features as intracranial meningiomas [3].
• Primary neoplastic processes: Other primary brain tumors, such as glioblastoma or metastatic disease, should be considered in the differential diagnosis [3].

Clinical Features

Intracranial meningiomas can present with a range of clinical features, including:

• Changes in voice and swallowing: These symptoms are often associated with intraventricular meningiomas [6].
• Decreased hearing and changes in facial strength or double vision: These symptoms can be caused by the tumor's location and size [6].

Diagnostic Methods

The principal diagnostic method of choice for intracranial meningiomas is magnetic resonance imaging (MRI) [5]. In vivo magnetic resonance spectroscopy (MRS) may also be used to aid in diagnosis.

References:

[3] Feb 11, 2024 — The differential diagnosis of cerebral mass lesions includes neoplastic, inflammatory, infective, and vascular lesions, ...

[4] by C Boulagnon-Rombi · 2017 · Cited by 111 — The most common differential diagnoses are schwannomas and other rare meningeal tumors, such as solitary fibrous tumor/hemangiopericytoma (SFT/...

[5] by DJ Jaskólski · 2013 · Cited by 18 — The principal diagnostic method of choice is magnetic resonance imaging (MRI), whereas in vivo magnetic resonance spectroscopy (MRS) is an au-.

[6] They can also lead to changes in voice and swallowing, decreased hearing and changes in facial strength or double vision. ... Intraventricular meningiomas arise ...

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