Understanding Meningiomas and Surgical Treatment

Posted by Brigham and Women's Hospital May 26, 2015

Pre-operative MRI of a meningioma

Authors: Tracy Ansay, MD, neurosurgeon, and Stanley Mui, physician assistant, of the Department of Neurosurgery at Brigham and Women’s Hospital. Dr. Ansay is also an Instructor in Neurosurgery at Brigham and Women’s Hospital.

We recently cared for a patient who was experiencing seizures despite being prescribed anti-seizure medications. He also was experiencing bouts of confusion. Both the seizures and episodes of confusion were very debilitating and impacted his performance at work. He was not able to drive and also was experiencing side effects from the anti-seizure medications, including irritability, cloudy thinking, and fatigue. An MRI indicated he had a brain tumor called a meningioma located in an area deep within the brain, next to an area called the cavernous sinus. His seizures were the result of pressure to the temporal lobe caused by the meningioma.

How Common are Meningiomas?

MRI after skull base surgery to remove the meningioma

Meningiomas are among the most common brain tumors. They are more common among women and occur with increasing frequency as people get older. Meningiomas are found in about three percent of people over the age of sixty.

Meninigiomas are typically attached to the covering of the brain called the dura, and they originate from cells within it. Approximately 90 percent of meningiomas are benign tumors. They also are slow-growing, with a diameter growth of about one millimeter per year. Atypical meningiomas, which grow more quickly, make up about seven percent of meningiomas. Malignant meningiomas, which are very rare, account for about two percent of meningiomas. Because meningiomas are usually benign and slow-growing, most patients can expect good outcomes after treatment.

Due to their attachment to the dura, meningiomas typically cause pressure on the brain, but do not actually invade brain tissue. Symptoms vary depending on where they are they located and may include weakness, numbness, or seizures. Most patients, however, do not experience any symptoms.

Restoring Quality of Life

Despite the challenging tumor location, our team was able to successfully remove this patient’s meningioma, with minimal disruption to the surrounding brain tissues, using a modified skull base surgical procedure. By using a less invasive surgical approach, our patient was able to return home two days after his surgery. Examination of the patient’s tumor indicated that it was benign. Follow-up MRI scans confirmed the tumor was completely gone and had not regrown. Our patient was tapered off his anti-epileptic medications, and his bouts of confusion and seizures stopped. Most importantly, he has been able to resume his normal activities and enjoy life once again

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Can a Trip to the Dentist Put You at Risk for a Brain Tumor?

Posted by Brigham and Women's Hospital July 6, 2012

Can a Trip to the Dentist Put You at Risk for a Brain Tumor?

Research suggests that frequent dental x-rays can heighten your risk of developing a brain tumor.

In the largest study of its kind, Brigham and Women’s Hospital (BWH) researchers, along with researchers from Yale University School of Medicine, Duke University, University of California, San Francisco, and Baylor College of Medicine, have found an association between past frequent dental x-rays and an increased risk of meningioma, which accounts for 33 percent of all primary brain tumors.

According to the study, patients with meningioma were twice as likely to report having a specific type of dental x-ray called a bitewing exam. Those who reported having them yearly or more frequently were 1.4 to 1.9 times as likely to develop a meningioma.

There was an even greater increased risk of meningioma in patients who reported having a panorex x-ray exam. Those who reported having this exam under the age of 10 were 4.9 times more likely to develop a meningioma. Those who reported having the exam yearly or more frequently than once a year were nearly three times as likely to develop meningioma.

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