The symptoms of a meningioma depend heavily on its size, location, and rate of growth. Since many meningiomas grow very slowly, they might not produce noticeable symptoms until they are quite large. When symptoms do occur, they are typically due to the tumor pressing on nearby brain tissue or nerves. According to Dr. Jaydev Panchwagh and insights from neurosurgerypune.com, common symptoms include:

• Headaches: Persistent headaches that may worsen over time, often accompanied by nausea or vomiting.
• Seizures: New onset of seizures, especially in adults.
• Neurological Deficits:
  • Weakness or numbness: Often on one side of the body.
  • Vision problems: Blurred vision, double vision, or loss of peripheral vision.
  • Hearing loss or Tinnitus: A ringing or buzzing sound in the ears, particularly if the tumor is near the ear.
  • Changes in smell: Anosmia or altered sense of smell if the tumor is near the olfactory nerves.
  • Speech difficulties: Trouble speaking or understanding language.
  • Balance and coordination problems: Dizziness, unsteadiness, or difficulty walking.
• Cognitive and Behavioral Changes: Memory problems, personality shifts, or difficulty concentrating.
• Hormonal problems: If the tumor is located near the pituitary gland.

It’s crucial to consult a neurosurgeon if you experience any of these symptoms, as early detection can significantly improve treatment outcomes.

The exact cause of meningiomas is not fully understood, but certain factors are known to increase the risk:

• Genetics: A small percentage of meningiomas are linked to inherited genetic disorders, such as Neurofibromatosis type 2 (NF2).
• Radiation Exposure: Exposure to radiation, particularly to the head, can increase the risk of developing a meningioma years later.
• Hormonal Factors: Meningiomas are more common in women, suggesting a possible link to hormones, as they have hormone receptors (especially progesterone receptors).

Age: The risk of developing meningiomas increases with age, most commonly diagnosed in older adults.

Accurate diagnosis is fundamental for effective management of meningiomas. Dr. Jaydev Panchwagh employs a meticulous diagnostic approach, leveraging advanced imaging and, when necessary, pathological analysis:

• Neurological Examination: A comprehensive assessment of reflexes, vision, hearing, balance, coordination, and cognitive function to identify any deficits.
• Imaging Tests:
  • MRI (Magnetic Resonance Imaging) with contrast: This is the primary diagnostic tool, providing detailed images of the brain and highlighting the tumor’s size, exact location, and relationship to surrounding structures. Dr. Panchwagh often uses advanced MRI techniques for detailed mapping.
  • CT (Computed Tomography) scan: May be used to assess bone involvement by the tumor or if the tumor is calcified.
  • Angiography: In cases where the meningioma has a rich blood supply or is close to major blood vessels, angiography can provide a detailed map of the vascular architecture, which is critical for surgical planning.

Biopsy: While imaging can strongly suggest a meningioma, a definitive diagnosis, including its grade (benign, atypical, or malignant), is made through a biopsy, where a tissue sample is surgically removed and examined under a microscope.

The treatment strategy for a meningioma is highly personalized, considering factors such as the tumor’s size, location, grade, the patient’s age, overall health, and the presence and severity of symptoms. Dr. Jaydev Panchwagh, with his extensive experience in treating brain tumors, offers a range of advanced options:

1. Observation (Watchful Waiting):
   • For small, asymptomatic meningiomas, especially in older patients or those with significant health issues, Dr. Panchwagh may recommend a “watch and wait” approach. This involves regular MRI scans to monitor the tumor’s growth. If the tumor grows or causes symptoms, treatment will be considered.
2. Surgical Resection (Craniotomy):
   • The Best Option for Cure: Surgical removal is often the primary and most effective treatment, especially for symptomatic or growing meningiomas. The goal is complete surgical resection while preserving neurological function.
   • Dr. Panchwagh’s Advanced Techniques:
     • Microsurgery: Utilizing high-power operating microscopes, Dr. Panchwagh performs highly precise tumor removal, minimizing damage to surrounding critical brain structures. This is particularly crucial for meningiomas attached to vital blood vessels or nerves.
     • Neuro-navigation: This GPS-like technology provides real-time, 3D images of the brain and tumor during surgery, guiding the surgeon with unparalleled accuracy.
     • Endoscopic Endonasal Surgery: For select meningiomas located at the skull base, this minimally invasive technique allows access to the tumor through the nasal cavity, avoiding traditional open surgery.
     • Skull Base Surgery: Dr. Panchwagh specializes in complex skull base meningiomas, employing advanced techniques to safely remove tumors in these challenging anatomical regions.
     • Cavitron Ultrasonic Aspirator (CUSA)
   • Benefits: Complete surgical removal often leads to a cure for benign meningiomas, with a potential for a normal life span.
3. Radiation Therapy:
   • Radiation therapy uses high-energy beams to destroy tumor cells or halt their growth. It may be used in several scenarios:
     • After incomplete surgical removal: To treat residual tumor and prevent recurrence.
     • As a primary treatment: For tumors that are inoperable due to their location or for patients who are not candidates for surgery.
     • For atypical (Grade II) or malignant (Grade III) meningiomas: Often used post-surgery to reduce the risk of recurrence.
   • Types of Radiation Therapy:
     • Stereotactic Radiosurgery (SRS): A highly focused, single-session radiation treatment for smaller tumors, delivering a high dose of radiation with extreme precision. (Gamma Knife Radiation)
     • Fractionated Stereotactic Radiotherapy (SRT): Delivers radiation in multiple smaller doses over several weeks, often used for larger tumors or those near sensitive structures like the optic nerve.
     • Intensity-Modulated Radiation Therapy (IMRT) and Proton Beam Therapy: Advanced techniques that conform radiation dose to the tumor’s shape, sparing surrounding healthy tissue.
4. Chemotherapy and Targeted Therapy:
   • Chemotherapy is rarely effective for most meningiomas and is generally considered only for aggressive or recurrent malignant meningiomas that have not responded to surgery or radiation.
   • Research into targeted therapies that specifically attack cancer cells is ongoing.