Meningioma is a tumor that occurs in the membranes (meninges) of the brain or spinal cord. The meninges are the membranes that protect the brain and spinal cord. Meningiomas are tumoral growths arising from the cells of these membranes. They are the most common benign tumors in the brain. They are tumors that are generally considered benign (non-malignant) because they grow slowly and do not damage brain tissue, meaning they are not cancer. However, in some cases, they can rarely become cancerous. Meningiomas are usually slow growing tumors and often grow outside the brain (extraaxial tumor) as they arise from the meninges. For the larger ones pushing the brain, they usually develop in light contact without damaging the brain tissue until the advanced stages. They may come into contact with the skull bones and rarely develop within the bone (intraosseous meningioma). Meningiomas usually occur as a single tumor, but sometimes more than one tumor may occur (meningiomatosis). It is not fully understood why meningiomas occur. However, certain factors are thought to increase the risk.
Risk factors may include:
Gender: Women are at a higher risk than men. Because estrogen and pregnancy hormones are nutritious for meningiomas.
Age: It is more common in advanced ages (after 60 years).
Radiation exposure: Especially in people who have been exposed to radiation in the head and neck region The risk may be increased.
Genetic syndromes such as neufibromatosis type 2 (NF2): People with such genetic syndromes are at a higher risk for meningiomas. Symptoms The symptoms of meningiomas can vary depending on the size, location and pressure of the tumor. pains. Weakness in fine motor skills: For example, decreased dexterity or balance problems.
Visual changes: Double vision, loss of vision or blurred vision.
Hearing problems: Hearing loss or ear ringing. Neurological signs: Neurological signs such as lethargy, loss of strength, muscle weakness or epileptic seizures. Hafiz Cognitive problems, such as not being able to recognize people around and not being able to find the direction, are complaints that usually occur in advanced ages and enable the tumor to be diagnosed. If a defect in brain functions such as reflexes, muscle strength, balance, coordination and sensory problems is detected during the procedure, brain imaging is usually requested from the patient. Brain imaging is also used in brain CT and brain MRI. MRI is the first method to be used in patients with suspected brain tumor.
Magnetic resonance imaging (MRI): MRI is a common method used to view the brain and spinal cord in detail. MRI helps determine the size, location, and other characteristics of the tumor. Contrast-enhanced MRI examines the tumor tissue more thoroughly and reveals its relationship with the meninges.
Computed tomography (CT): CT scans can help show the location and structure of tumors. Contrast-enhanced CT scans using contrast material can help make tumors more clearly visible. In addition, CT is preferred as the method that gives the best information if the tumor has a feature of calcification, its relationship with bone structures or if it has caused bone destruction. Treatment Treatment options for meningiomas may vary depending on the size and location of the tumor, the patient's quality of life, general health, and other factors. requiring observation. Since the growth rate of the tumor is low, especially in patients aged 70 and over, observation is recommended first if the tumor size is small and does not damage the brain tissue. In this case, regular annual imaging tests are done to monitor the growth of the tumor and the appearance of symptoms. Surgical intervention: Surgical removal of meningiomas is evaluated depending on the size and location of the tumor and the general health of the patient. Surgery usually aims to remove the tumor completely. However, sometimes complete removal of the tumor is difficult or risky. can. In this case, surgery may aim to remove most or the pressing portion of the tumor. In young patients, if the tumor has caused a neurological defect, it should be operated first, regardless of its size. Tumor size is checked in tumors that do not cause neurological defects. Observation or Gamma-Knife radiosurgery can be applied in tumors with dimensions of 3 cm or less. Tumors exceeding 5 cm in size should be surgically removed because of the high risk of growth. In patients over 60 years of age, observation or Gamma-Knife radiosurgery can be performed if the tumor does not cause neurological defects and its length is less than 5 cm. Regardless of tumor size, surgery should be considered in patients with neurological defects. methods are used. Stereotactic radiosurgery, in the treatment of meningioma, aims not to eliminate the tumor with focused high-energy beams, but to shrink the tumor or at least to stop its growth. The treatment is done with millimetric precision, focusing on a single point with irradiation channels positioned from 270 degrees. Radiotherapy can be used in cases where the tumor cannot be completely removed (residual tumor) after surgery or in cases where surgery is not suitable. The decision to treat is based on factors such as the characteristics of the tumor, the patient's health status, the severity of symptoms, and the patient's preferences. A multidisciplinary approach is adopted, working with specialists such as a neurologist, neurosurgeon, and radiation oncologist to make this decision. The patient is informed in detail about treatment options and risks and is included in the decision-making process.
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