Meningioma of the Brain Surgery in New Jersey

Doctor examining brain scans and pointing at tumor with pen

A brain meningioma is a common type of tumor that is typically noncancerous. However, if it grows large enough, it can begin to cause symptoms that are too problematic, thus requires surgery to remove the tumor. Centers for Neurosurgery, Spine & Orthopedics (CNSO) is a multi-specialty medical provider providing spine surgery and brain surgery, including brain meningioma surgery, to patients throughout northern New Jersey. Learn more about brain meningiomas and the treatment options available at CNSO.

What Is Meningioma of the Brain?

Meningioma of the brain is the most common kind of primary brain tumor, accounting for about 30% of all brain tumors. Meningiomas usually are benign, or noncancerous, although they can be cancerous in some cases. Meningioma forms in the meninges, which are three membranes covering the brain and spine to help protect them. These tumors usually grow slowly but can become large over time. If the tumor grows too big, it can press on surrounding blood vessels, interrupting blood flow to the brain, spinal cord, and nerves. This can result in disabling and even life-threatening side effects, which require treatment to remove the tumor. However, most meningiomas grow slowly enough that they do not cause significant symptoms. This allows the tumor to be monitored over time instead of going straight to more aggressive treatments.

Meningioma of the Brain Classifications

Each meningioma tumor is classified into a grade depending on whether it is cancerous, its location, and whether it has spread. To determine the grade, doctors will remove a sample of the tumor and examine it under a microscope. The findings help them categorize the meningiomas into three grades:

Grade I (benign):This is the most common type of meningioma and is noncancerous, slow-growing, and has distinct borders.
Grade II (atypical):This second most common meningioma has tumor cells that are not normal and tend to grow and recur faster than Grade I tumors.
Grade III (malignant or anaplastic):This is a rare and aggressive form of meningioma that is cancerous and invades nearby parts of the brain.

About 80% of meningiomas are benign or Grade I, and 20% are either atypical or malignant (Grade II or III). Knowing the grade of the tumor helps provide valuable insight into the best treatment option, prognosis, and recovery.

Meningioma of the Brain Symptoms

A patient with a brain meningioma may not experience symptoms because the tumor often grows very slowly. When patients do have symptoms, they can be overlooked or attributed to other health conditions or to aging. The symptoms also can depend on the tumor’s grade and exact location in the brain. Patients with faster-growing tumors, like Grade II or III meningiomas, usually will experience more symptoms that require removal of the tumor. These symptoms may include:

Changes in vision such as seeing double or blurriness
Headaches, especially in the morning
Seizures
Hearing loss
Ringing in the ears (tinnitus)
Memory loss or confusion
Problems with smell
Loss of balance
Drowsiness
Weakness or numbness in arms or legs
Language difficulty

Not all patients with brain meningioma will experience any or all these symptoms. However, patients who have been experiencing concerning symptoms should make an appointment with their doctor to discuss further testing.

Meningioma of the Brain Risk Factors and Causes

The exact causes of meningioma of the brain are not known, but there are certain risk factors associated with a higher chance of developing one. These include:

Age

The older a person is, the greater the risk is that they will develop brain meningioma, although it can happen in people of all ages. The condition is most often diagnosed in patients who are 65 or older and least common in children 15 and younger.

Gender

Women are 50% more likely to develop a noncancerous meningioma than men. However, men and women have the same likelihood of developing cancerous meningiomas.

Race

People of color have a higher risk of developing meningioma than white people, but Black people have the highest rate of meningiomas among ethnicities in the U.S.

Genetics

People who have certain inherited conditions, such as neurofibromatosis type 2 (NF2), multiple endocrine neoplasia type 1 (MEN1), or schwannomatosis are much more likely to develop cancerous meningioma and multiple meningiomas.

Obesity

Studies have shown a higher rate of meningiomas among people who are obese than people who are not.

Radiation Exposure

Exposure to radiation treatment, in both high and low doses, has been linked to a higher chance of meningiomas. This typically occurs from radiation therapy to the head from previous cancer treatment. Although these risk factors can increase the chances of a person developing meningioma, it does not mean that everyone with one or more of these factors will be affected by it.

Diagnosing Meningioma of the Brain

When a patient presents with symptoms of brain meningioma, they typically will be referred to a neurologist for diagnostic testing. However, meningiomas can be tricky to diagnose without imaging because they are slow-growing and may not have clear symptoms. Neurosurgeons or neurologists will use a variety of diagnostic tests to diagnose meningioma of the brain, including:

Physical and Neurological Exams

Exams of a patient’s physical body and neurological abilities can help the doctor understand more about the symptoms and location of the tumor. Vision and hearing tests can give insight into what part of the brain is affected. Neurological exams are used to test a patient’s reflexes, memory, balance, coordination, and other capabilities to see the effects the tumor may be having on the body.

Computed Tomography Scans (CT scans)

CT scans work by taking X-ray images of the affected area to create 3-D images that can be used to identify and locate tumors or other abnormalities. In terms of meningiomas, CT scans can take detailed images of the head to visualize the brain, identify the location of the tumor, measure its size, and find changes in the skull resulting from the tumor.

Magnetic Resonance Imaging (MRI)

MRIs are used to create extremely detailed images with magnetic fields and are the preferred method for diagnosing brain meningiomas. This is because MRIs are much more sensitive than CT scans and can offer extra details that are valuable for confirming a diagnosis. They also help provide information about how the tumor is affecting the brain and surrounding tissue. Meningiomas are distinctive on an MRI because they have a unique dural tail that other tumors do not.

Cerebral Angiogram

Cerebral angiograms are a unique type of head x-ray used to show the arteries in the brain. This imaging uses a special contrast dye injected into the patient, which lets the doctors see how the meningioma is impacting the brain and nerves.

Biopsies

Sometimes a biopsy may be recommended to definitively determine a diagnosis if imaging has failed. However, meningiomas usually are just removed instead of doing a biopsy and a separate removal surgery. The tests used for diagnosis will vary from patient to patient, depending on their symptoms, age, general health, and other factors. Occasionally, meningiomas of the brain are discovered and diagnosed only because they are noticed on imaging done for another reason, such as a head injury, stroke, or other condition.

Meningioma of the Brain Treatment Options

Once a patient has received a brain meningioma diagnosis, their doctor will go over the possible treatment options and help them determine the best course. The treatment option prescribed depends on factors such as the tumor’s size, location, and growth rate. Treatments for meningiomas of the brain include:

Active Surveillance

Active surveillance refers to the process of watching and waiting to monitor the meningioma for changes that require more active treatment. This is suitable for patients with slow-growing Grade I tumors that have mild or no symptoms. It also is a treatment alternative for patients who cannot handle more invasive treatment options like surgery. However, more active treatment will be required if the surveillance shows concerning changes.

Surgery

Surgery is the main method for treating meningiomas of the brain. Using a procedure called a craniotomy, or endoscopic brain surgery, the neurosurgeon will open the skull over the area in the brain where the tumor is. Then, they will remove as much of the tumor as possible, including surrounding fibers, while paying special attention to preserving the patient’s neurological functions. Surgery is the most common method of treating meningioma, but it can come with risks of bleeding, infection, and other side effects. Patients need to discuss the risks and benefits of surgery for their case as it may not be ideal for all patients. Tumors that are in difficult-to-reach or delicate areas of the brain sometimes cannot be removed completely. However, the surgeon will remove as much of the tumor as possible. Grade I tumors often can be successfully removed completely with surgery, offering the best prognosis. If they cannot be removed in their entirety, patients may undergo follow-up scans or radiation treatment to monitor or treat the remaining pieces. Grade II or III grade tumors usually need radiation therapy to treat the remaining tumor cells.

Radiation Therapy

Radiation therapy uses high-energy beams of X-rays or other particles to destroy tumor cells. Radiation therapy can be used in conjunction with surgery or on its own. There are many types of radiation therapy, and some are better than others for meningiomas. These include:

Stereotactic radiosurgery (SRS):SRS is a type of radiation treatment that can be used for people with recurring meningiomas or those that cannot be removed with conventional surgery.
Intensity-modulated radiation therapy (IMRT):IMRT is suitable for meningiomas with a unique shape or located near sensitive brain structures.
3-dimensional conformal radiation therapy: This therapy helps deliver more precise radiation to the tumor and less to the surrounding healthy tissues.

The type of radiation therapy used will depend on the size, grade, and location of the meningioma. These treatments can be used alone or together for the best outcome. Sometimes, meningiomas can recur after being treated and additional treatment may be needed. At Centers for Neurosurgery, Spine & Orthopedics, the multi-specialty doctors and surgeons collaborate to provide patients with the best quality care. CNSO takes a conservative approach to treatment, suggesting less invasive measures before recommending more invasive options like surgery and radiation therapy.

Recovery From Brain Surgery

The recovery process from surgery will depend on the method used for surgery, the size, location, and severity of the tumor, and the patient’s general health. Patients undergoing a craniotomy or endoscopic brain tumor removal of a meningioma may need to stay in the hospital for a few days. At CNSO, our neurosurgeons use minimally invasive brain surgery, including endoscopic brain surgery to remove meningiomas whenever possible, which lets patients return home in as little as two to three days. Patients typically will be given prescription medications to help with pain, inflammation, and other side effects of surgery. Activity restrictions also will be given to help the body recover and heal properly. The recovery process usually takes anywhere from two to 12 weeks.

Meningioma of the Brain Outcome

Since brain meningiomas can be either benign or cancerous and in different stages of development, the outcome for this type of tumor varies. The 10-year-survival rate for patients with benign meningiomas is 84%, while the survival rate is 62% for patients with cancerous meningiomas. Patients should keep in mind that the survival rate is just an estimate and cannot predict any one person’s rate of survival. However, research has shown that the age of the patient at the time of meningioma diagnosis is one of the biggest predictors of outcome. Generally, the younger the patient is at diagnosis, the better their prognosis tends to be. There also usually is a better prognosis if the entire tumor is removed surgically, but this is not an option for all patients.

Brain Meningioma Treatment at CNSO

Centers for Neurosurgery, Spine & Orthopedics practices a patient-centered model of care to keep our patients happy, healthy, and satisfied. CNSO is proud to have an experienced team of board-certified specialists who work tirelessly to provide comprehensive care for our patients throughout northern New Jersey. The CNSO team includes:

Neurosurgeons
Interventional pain management physicians
Physiatrists
Rehabilitation specialists
Certified physical therapists

These CNSO specialists use an interdisciplinary approach to provide personalized treatment plans for each patient. For patients with meningiomas of the brain, CNSO offers minimally invasive brain surgery that uses state-of-the-art technology to remove the tumor. This process minimizes incisions and scarring while offering a quicker recovery time and higher success rates. Most patients who have minimally invasive meningioma removal surgery at CNSO can go home within a few days.

Request an Appointment to Discuss Brain Meningioma Treatment

Whether a patient already has a confirmed meningioma of the brain or suspects one, Centers for Neurosurgery, Spine & Orthopedics can provide comprehensive care to help them heal. Providing diagnosis and treatment for brain, spine, and nerve problems, CNSO is the trusted place to go for patients in northern New Jersey. Contact us today to request an appointment at one of our multiple convenient locations in Bergen, Passaic, Essex, Hudson, and Morris counties.