Il meningiomas is a brain tumor, usually benign which concerns the meninges, but it can also involve surrounding nervous tissue through compression. It's worth remembering how the meninges are structured.
What are the meninges like?
The meninges are membranes that surround the brain and spinal cordThey are made up of three layers, going from the inside out:
- pious mother, where blood vessels carry nourishment to the surface of the central nervous system
- arachnoid
- dura mater, within which blood vessels supply the skull
Classification of meningiomas
The World Health Organization has classified meningiomas by identifying 15 types based on the morphology of the cells that compose them (histological subtypes):
- Grade I Benign
- Grade II Atypical, which grows more rapidly and can expand into the brain. If atypical, the cerebral meningioma can reform more easily.
- Grade III Malignant, characterized by even faster development and more marked cellular abnormalities. It has an even greater chance of spreading and recurring.
The risk factors
Some categories of subjects are at greater risk of developing a meningioma, which occurs more frequently in women (2 times more than men) and in general in people between 30 and 70 years. It is precisely the higher incidence in female subjects that has made scientists focus their attention on the relationship between brain meningioma and hormonesEstrogens, progesterone, and androgens have been detected in some of these tumors, and their development is also linked to the menstrual cycle, pregnancy, and breast cancer. It should be noted, however, that the risk of diagnosing a malignant meningioma is three times higher in men than in women. Meningioma is rarer in children, although a link between this tumor in pediatric age and radiation exposure has been observed in some cases. ionizing. Finally, the role of the neurofibromatosis type 2, a genetic disorder that increases the risk of developing malignant or multiple meningiomas. Meningiomas are not hereditary, but can become hereditary as a consequence of this disorder.
Meningioma: symptoms and types
Meningioma can cause symptoms such as:
- headache
- convulsions
- mood and behavioral disorders
- drowsiness
- confusion
- progressive focal neurological deficit
- hearing loss or tinnitus
- vision disorders
- muscle weakness
- nausea
- vomiting
Depending on the location of the meningioma, it is identified with a specific typology, which in turn can manifest itself with characteristic symptoms:
- cavernous sinus meningioma, in the venous plexus that drains venous blood from the brain to the heart
- cerebellopontine angle meningioma, near the lateral margin of the cerebellum
- meningioma of the cerebral convexity, on the brain surface just under the skullcap, which can lead to headaches, seizures, neurological deficits
- meningioma of the foramen magnum or foramen magnum
- intraorbital meningioma, which can cause increased pressure inside the orbit and consequently the protrusion of the eyeballs and, in the most serious cases, loss of vision
- intraventricular meningioma, in the cavities where the cerebrospinal fluid passes. If it is blocked, it can develophydrocephalus obstructive, with headache, dizziness and altered mental functions
- olfactory groove meningioma, along the nerves that connect the brain and nose and allow us to perceive smells. If the compression on the nerves is intense, loss of smell and vision can occur.
- parasagittal and falx meningioma, statistically the most common, which can present with alterations in thinking and memory, convulsions, numbness of the lower limbs
- petrous rock meningioma, the part of the temporal bone where the organs responsible for hearing are stored
- posterior fossa meningioma, in the back of the brain. This type can cause hearing loss, balance problems, and coordination.
- sphenoid meningioma, near the sphenoid bone, which can manifest with vision problems, facial numbness, and seizures
- spinal meningioma, located in the spine, linked to possible back and limb pain
- suprasellar meningioma, in the area where the pituitary gland is located, which can cause vision problems
- tentorial meningioma, at the connection point between the brain and the brainstem
Meningioma: from diagnosis to surgery
It is not easy to recognize the symptoms of a cerebral meningioma, which can develop very slowly and is not characterized by such specific symptoms. The most commonly used tools are: computed tomography , magnetic resonance, although sometimes the only method to obtain a certain diagnosis is the biopsy performed by the neurosurgeonThe timing of diagnosis is very important: the younger the subject, the more positive the prognosisAlthough meningioma usually does not affect life expectancy (when benign), it can affect quality of life if symptoms are severe. It is therefore important to identify the right treatment. Since cerebral meningioma usually has a specific extension, Complete surgical removal is the best optionThe surgery is performed with a craniotomy to access the tumor, which is removed along with the fibers that connect it to the coverings of the brain and bones. Naturally, the possibility of surgery must be carefully evaluated, based on the individual patient's situation. If the meningioma cannot be surgically removed, the radiotherapy can be considered an alternative. Is there a pharmacological cure for meningioma? Actually, no, although research has evolved to achieve chemotherapeutic agents more targeted to treat the malignant tumor. In some cases, meningioma manifests itself with calcified, or ossified, elements: the calcific meningioma It is more common in older people and in general it does not need to be treated.
