Meningiomas: Prominent Expert’s Q&A on the Most Common Brain Tumor

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07/03/23

Meningiomas represent about 1 out of 3 primary brain and spinal cord tumors. They are the most commonly diagnosed primary brain tumors in adults. And although they evolve in the meninges, the layers of tissue that surround the outer part of the brain and spinal cord, they are referred to as brain tumors

The vast majority of meningiomas are benign, but these tumors can grow slowly and, if left undiscovered, can be severely disabling and life-threatening depending on their location. About 10 to 15 percent of meningiomas are malignant, or cancerous.

Michael McDermott, M.D.., a neurosurgeon and the chief medical executive of Miami Neuroscience Institute, is a world-renowned leader in neurosciences, with a clinical expertise in the field of meningioma surgery.

“I would say that the greatest proportion of meningiomas are discovered by chance,” explains Dr. McDermott. “Because of the wide availability of modern imaging, particularly with magnetic resonance imaging (MRI), studies are done for other reasons. That’s why these tumors are frequently discovered.”

Dr. McDermott is the editor of two books that were recently published: Handbook of Clinical Neurology: Meningiomas, Part 1, Vol. 169 (2020); and Part 2, Vol. 170 (2020).

[Transcript]
Michael McDermott:
Meningiomas are the most common primary brain tumor in adults over the age of 35 until death. Approximately 70% of these are low grade, benign-behaving tumors. They don't have symptoms specific to the tumor site and there's no documented growth, then there's no role for intervention. The patient can be safely observed. Most common symptoms for an adult patient with a brain tumor of any type are: headache, seizures, progressive focal neurologic deficit. Well, what does that mean? That means if the tumor overrides your motor cortex, you develop weakness on the other side, if it's over your sensory cortex, you develop sensory symptoms, it's over visual, develop visual. And then the other one is change in personality or behavior.
Surgery is still considered the primary treatment for meningiomas, especially when the tumors are symptomatic. So if you came in with a seizure first time, grand mal seizure, as your initial presentation for meningioma, the meningioma itself is not the cause of the seizure. It's the effect of the meningioma on the adjacent normal brain, that's causing the seizure. So if you remove the inciting culprit, so to speak, then you can reduce the likelihood of future seizures and you can reduce the likelihood of an epilepsy syndrome, which means recurrent, repetitive seizures in spite of medication.