The human brain is covered with three membranes – dura mater (outer), arachnoid membrane (in the middle), pia mater (directly adjacent to the brain).
Meningiomas grow from the arachnoid membrane (hence their previous name “arachnoendothelioma”).
Meningioma is, in most cases, a benign extracerebral tumor. It comes from the membranes of the brain that cover the brain on all sides, so these tumors can occur in any area. Meningiomas are most common in people of working age – 35 – 60 years.
Meningioma has been studied both in Ukraine and abroad. Meningiomas are classified according to the type of cells (the term “grade” is used in the English language literature):
Grade I are benign tumors (approximately 90%) that grow relatively slowly. The older the patient is, the slower they grow.
Grade II is the so-called atypical meningiomas (about 8-9%). They are characterized by faster growth and a tendency to invasion, i.e. fouling of important vessels, nerves and destruction of the bones of the skull.
Grade III – this is about 1% of meningiomas, which are called anaplastic and refer to malignant neoplasms that, in addition to surgical treatment, require compulsory radiation therapy. Establishing the type of tumor and the degree of its malignancy is possible exclusively by direct examination of the tumor tissue, which is surgically removed (pathohistological and immunohistochemical study). All other research methods cannot be considered reliable.
Also, meningiomas are divided depending on the location, i.e. from the head area where they are. Meningiomas can be conventionally divided into:
Convexital – those that are adjacent to the outer surface of the brain
basal are those that adjoin the lower surface of the brain and grow from the base of the skull.
Basal meningioma of the brain is more difficult to treat. This is due to the fact that vital vessels (carotid artery, main artery and their branches), cranial nerves are located at the base of the skull, as well as the brain stem is located at the base of the skull – this is the formation of the nervous system, where the centers of respiration, blood circulation, etc. are located. etc.
The size of the tumor is also an important factor. The larger the neoplasm, the more difficult its surgical removal. This is especially true for basal meningiomas. Increasing in size, the tumor begins to press on the brain stem, and then displace it, causing impaired blood circulation in it. The larger the meningioma of the brain, the greater the likelihood of overgrowth of vital vessels and cranial nerves.
Headache. This is the most common symptom and is present in almost all patients. Due to low medical culture, this symptom is often ignored and treated with “folk remedies”. The headache is often local in nature – the back of the head, “pressing on the eyes,” etc. Headache is a nonspecific symptom, however, if it appears in the morning for a long time, and especially when the pain is accompanied by nausea and vomiting, the patient MUST consult a doctor.
Dizziness. Also among the nonspecific symptoms, dizziness should be noted. Patients often attribute this to “overwork” and “constant stress.” However, if dizziness appears, which does not respond to the “usual” treatment, you should also consult a specialist.
visual impairment, vision “like in a tunnel”, strabismus, double vision, skewed face, hearing loss in one or both ears, noise in the ear / ears, violation of sensitivity or pain in half of the face, changes in voice, hoarseness or trouble swallowing, seizures, gait disturbances, dizziness.
At first, the symptoms may be solitary, but others are added over time. Since in most cases, meningiomas are benign tumors, they grow slowly over the years and, accordingly, the symptoms grow just as slowly, until the period when the brain can no longer compensate for the compression of an already large tumor.
If the patient develops the above symptoms, then you MUST CONSULT a specialist. The doctor performs a neurological examination and determines the type of examination.
With the modern development of diagnostics in Ukraine, they usually start with neuroimaging methods of examination: computer (CT), magnetic resonance imaging (MRI of the brain). These two surveys are basic. The interpretation of the data obtained is carried out EXCLUSIVELY by a SPECIALIST (the radiologist does not give a conclusion on the diagnosis, but only describes the changes found). After the received data, the doctor independently determines the list of additional examinations: encephalogram, dopplerography, the need to introduce contrast, angiography, etc.
The appointment of additional examination methods is determined only by a specialist. Self-examination of the patient often leads to the use of uninformative or redundant methods.
After further examination, the doctor may suggest several treatment options. The choice of treatment method is decided TOGETHER BY THE DOCTOR AND THE PATIENT after explaining to the patient the prospects of the disease and all possible existing treatments for this pathology.
Observation of the tumor. Given the fact that meningioma is a tumor that often grows slowly, in patients with no neurological symptoms, severe comorbidities, in old age, this option is allowed.
Surgical treatment. In today’s world, surgical treatment is the method of choice and the most common. The essence of treatment is the direct removal of all or most of the tumor and its histological examination. The main principle of surgical treatment is to preserve and improve the quality of life of the patient, so it is not always advisable to completely remove the meningioma. When planning the operation and during the intervention, the surgeon decides what is best for the patient – complete or partial removal with the addition of other treatments. This factor is also influenced by the patient’s age, the presence of concomitant diseases (diabetes, stroke or myocardial infarction, etc.), the location and growth of meningiomas with the overgrowth of vital brain structures. This, in turn, requires the use of a microscope, ultrasound aspirator, endoscopic technique, cranial nerve monitoring and many other modern tools that are standardly used in our clinic.
Radiation treatments are radiosurgery or radiotherapy, which are also performed at the Institute of Neurosurgery.
Radiotherapy is very rarely used as the only treatment. More often it is an adjunct to surgical treatment for atypical and anaplastic forms of meningiomas.
In most cases, the patient’s stay in the neurosurgical hospital takes about 7-10 days. Depending on the location of the meningioma, the patient’s activation occurs in the shortest PERMISSIBLE time. The doctor together with the patient, depending on many factors, determines these terms.
Regarding complications after treatment, our clinic avoids words such as “guarantee” or “one hundred percent result”. Neurosurgical operations are one of the most difficult in medicine, especially in cases of cranio-basal location of tumors, so we consider the use of such terms incorrect. You will receive COMPLETE AND CLEAR information during the conversation with your doctor. At the same time, we should note that our clinic is the ONLY SPECIALIZED IN UKRAINE since 1988 with the most experience and, accordingly, the best treatment results.
Each of the treatments has its ADVANTAGES AND DISADVANTAGES. When you see a neurosurgeon, be sure to explain in detail all the possible treatment options, risks and possible consequences. The conversation between the patient and the doctor DEPENDS ON THE INDIVIDUAL CASE.
You can get a detailed consultation about your disease and answers to all questions in our clinic, which has been specializing in the treatment of this pathology for over 30 years and has the most experience in Ukraine.
In the conditions of a quarantine situation we are ready to offer you the expanded online consultation. We understand your problem which should not be ignored due to the COVID situation.