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These tumors grow from the meninges, the layers of tissue covering the brain and spinal cord. As they grow, meningiomas compress adjacent brain tissue. Symptoms are often related to this compression of brain tissue, which can also affect cranial nerves and blood vessels. In some cases, meningioma growth can also extend into the bones of the head and face, which may produce visible changes. Most meningiomas are considered nonmalignant or low grade tumors. However, unlike nonmalignant tumors elsewhere in the body, some of these brain tumors can cause disability and may sometimes be life threatening. In many cases, meningiomas grow slowly.
Other meningiomas grow more rapidly or have sudden growth spurts. There is no way to predict the rate of growth of a meningioma or to know for certain how long a specific tumor was growing before diagnosis. Meningiomas are graded from low to high. The lower the grade, the lower the risk of recurrence and aggressive growth.
Treatment Options
Many patients with meningioma have no symptoms. For these patients, carefully watching the tumor is often appropriate. Evidence from studies which track patients for many years suggest that as many as two-thirds will not have symptoms over time. If the tumor is pressing on surrounding tissue, with or without symptoms, the treatment of choice is usually to surgically remove the tumor (resection).
Surgery
Surgery is usually the first approach. Because meningiomas tend to have well-defined edges and do not invade the brain, complete removal is sometimes possible. The standard treatment is to remove the tumor, the portion of the lining of the brain or spinal cord where it is attached and any bone involved.
However, many tumors are at the base of the brain near cranial nerves and blood vessels. Surgery to remove these tumors is more complicated because of the risk of damaging the nerves and blood vessels. Complete surgical removal is sometimes not possible.
each type of brain tumor arises from a specific cell type. The cell of origin for the meningioma is call the arachnoid cap cell, found on the surface coverings (called meninges) of the brain in the paccionian granulations. These serve as the one-way valve system between the water system of the brain and the veins that drain from the brain to the heart.
Meningiomas are rarely malignant in their behavior. But when malignant, meningiomas grow rapidly and are destructive; they are quite difficult to treat, and recur oftentimes in less than a year after surgical removal. They are also difficult for the pathologist to diagnose under the microscope. Probably the only finding that correlates well with the diagnosis is that of numerous cells seen in division ("mitosis"). The pathologist may occasionally speak of brain and skull invasion, cells with an abnormal appearance, or other bizarre findings, however none of these completey fit the diagnosis. Ultimately, the diagnosis is determined by the activity of the particular tumor over time.
Meningiomas are usually slow-growing and only around 10 percent is said to grow from the spine. Most of these come from the insides of the brain which is usually from the cerebral sphere. Those which are at the base of the brain are usually the ones which are hard to reach and would need special effort to extract without disturbing other parts of the brain.
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