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When a Jain Guru with 1 million followers was losing his sight—and traditional surgery failed—his followers sought sight-saving endonasal brain surgery at UPMC in Pittsburgh.
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A meningioma is a tumor of the protective linings of the brain and spinal cord. These linings are called meninges. Most meningiomas are benign, though some may be cancerous.
Benign meningioma tumors are generally slow growing. They usually don't cause problems unless they are pushing on the brainstem and/or compressing structures such as optic and cranial nerves.
Malignant (cancerous) meningiomas are faster growing, often cause neurological problems, and can cause swelling in the brain.
Meningioma tumor symptoms may include:
Treatments for meningiomas vary, depending on the type and location.
The neurosurgical team at UPMC may recommend a combination of surgical and non-surgical approaches for treating meningiomas:
To diagnose a meningioma, your doctor will:
Symptoms of meningioma are usually related to the area of the brain that is affected. Often the symptoms are caused by increased pressure within the skull.
Symptoms may include:
Your doctor will request imaging and diagnostic procedures such as CT and MRI scans, angiogram, and electroencephalogram (EEG).
You will also be given a neurologic test to assess your motor skills.
Often both benign and malignant meningiomas require some form of treatment. These treatment options could include surgery and/or stereotactic radiosurgery, depending upon the location of the tumor and symptoms.
Our neurosurgical team may recommend a combination of surgical and non-surgical approaches to maximize the benefits of surgery while minimizing the risks.
Malignant meningiomas are surgically removed whenever possible, while benign meningiomas are removed if they are large and/or causing neurologic problems.
The type of procedure depends on the size and location of the tumor.
At UPMC, we take a 360° approach to treatment when evaluating you. We look at your condition from every direction to find the path that is least disruptive to your brain, critical nerves, and ability to return to normal functioning.
Several minimally invasive surgical options allow UPMC surgeons to access areas that previously were difficult or impossible to reach.
Meningiomas of the skull base and upper spine may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the meningioma through the nose and nasal cavities.
EEA treatment offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.
Tumors located in the following areas can be treated with EEA:
If you need complementary treatments, such as radiation, those therapies can begin soon after EEA surgery.
Neuroendoport surgery offers a minimally invasive option for tumors within the ventricles (fluid spaces) or deep-seated tumors within the substance of the brain. A narrow tube or port allows surgeons to access these tumors through a tiny incision in the scalp, in contrast to traditional brain surgery.
Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incision.
Gamma Knife treatment may be used as a primary management option or after surgery for residual meningiomas. For small skull base meningiomas it may be the primary, minimally invasive option. For malignant meningiomas, in addition to surgery, both Gamma Knife radiosurgery and radiation therapy may be needed.
As the nation's leading provider of Gamma Knife procedures, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.
Chemotherapy is used only in the treatment of malignant meningiomas. Several medications are available and are generally used in conjunction with surgery and radiation therapy.
» Read the EEA Olfactory Groove Meningioma case study.
This animation illustrates the removal of a metastasis using the Neuroendoport technique.
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Pituitary tumor removal using the Endoscopic Endonasal Approach (EEA) at UPMC.
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Dr. L. Dade Lunsford discusses Gamma Knife Radiosurgery.
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Dr. Johnathan Engh discusses the benefit of Neuroendoport® surgery to remove brain tumors.
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