Expert Q&A: Recently Discovered Meningioma: Is This Fatal?
Q: After a scary episode in which I experienced disrupted vision, flashing lights and numbness in my extremities, I was told to get a CT scan. The initial scan picked up a meningioma in my occipital/parietal region. I'm waiting for another scan, but I have no idea what this could mean. Are meningiomas fatal?
First of all, the episode, which included a temporary disruption of vision with flashing lights and numbness (and subsequently improved), in the setting of a nearby brain tumor, implies a seizure. Not all seizures involve the classic "shaking" that the general public is familiar with. Any tumor pressing on the brain (specifically, the cerebral neocortex, or the upper, outer part of the brain) can cause a seizure.
The CT scan "picking up a meningioma" is a likely diagnosis, not a definitive one. The only definitve "gold standard" diagnosis is doing a biopsy or removal of the brain tumor, looking at the tumor portion under a microscope (pathology analysis) and determining a "meningioma." Although most diagnoses of meningioma can be highly suggested by a CT or MRI scan, occasional other tumors can mimic a meningioma in appearance.
Meningiomas, generally, are benign tumors which are not fatal (unless they grow and push on important brain structures enough to cause a problem). They typically grow slowly over years; certain meningiomas are more common in middle-aged women. Only rarely are meningiomas more aggressive, and these can be cancerous - but the overwhelming majority are benign, or not cancerous. There are several options of dealing with a meningioma: (1) do nothing and observe, to ensure it isn't increasing in size, by doing another CT or MRI scan in a few months, as seems to be the case in this scenario - if the tumor (presumed meningioma) is not growing, then another scan can be done in the future to ensure it still isn't growing; (2) operate and remove the tumor, if it is in a location that is not too risky - in terms of surgical resection, the more that is removed, the better a patient does as the lower the chance of it re-growing (or "recurring"); (3) Gamma Knife radiation (or other radiation) - by focusing radiation on the tumor, the tumor may either be prevented from growing or be reduced in size - however, the result is not instant as in surgery, and can take months... attention needs to be paid to minimizing surrounding brain radiation and subsequent damage to the brain, as in any procedure.
So, overall, in this scenario, the size of the meningioma is important - if it's a small meningioma, it can be observed; if it's large, it can be resected, and if it's somewhere in between, radiation vs. observation vs. surgery may be options. As far as the flashing lights (probable seizure) episode, a brain wave test (called an electroencephalogram, or EEG) can show if there is an irritable part of the brain possibly requiring anti-seizure medications (often done by a neurologist), and removal of the tumor may help with fewer such episodes (although not always guaranteed, due to to the irritability of the brain despite removal of the tumor). While every case is different, and I would need to know specifics, we are speaking in "generalities" about tumors like meningiomas, and the right answer is often best found in consultation with a patient's specific neurosurgeon.
Dr. Ravish Patwardhan is the founder and director of Comprehensive Neurosurgery Network, which specializes in minimally invasive techniques treating brain and spine problems, and has expanded remarkably, reporting a four-fold increase in staff and hundreds of operations yearly. He is only one of a few in the world to have performed certain procedures such as the Visualase laser probe technique to eradicate a brain tumor in an awake patient. He also has numerous innovations. Dr. Patwardhan has performed operations on both pediatric and adult patients and was named among the best neurosurgeons in the region in his first year of practice. Dr. Patwardhan has more than 12 years of experience in the neurosurgery industry and has published several peer-reviewed studies on brain trauma, tumors, epilepsy, and spinal procedures. He is also a frequent speaker on the newest treatments and advances on brain and spinal surgeries.
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