Meningiomas represent 10-15% of all intracranial tumours and arise from arachnoid cells. Commonly occur in mid-life and show a distinct female predeliction (~ 2:1). Familial cases have been described in literature but most are sporadic. Most meningiomas are benign but can cause problems dependent on their location (CT and MRI scan normally after neurological symptoms - that may be present for several years). Incidental finding sometimes or undiagnosed till autopsy. Hormones do affect tumours (meningiomas). But the effect is not totally understood yet. Certain tumours display more receptors than other tumours for unknown reasons. The implication medically is that medicine could be used to block the action of such hormones. Hormonal blocking medication in cases of glial tumours.


Tumour pathology can play a role. Most are benign. French abortion pill Ru 486 has been used to treat malignant meningiomas. This is an anti progersterone medication. Meningiomas can be checked to see if they have oestrogen or progesterone receptors but then what to do with this information? Not exactly known to date. Best therapy is complete resection. But cannot always do this. Tumour is adherent to important structures such as cranial nerves and blood vessels. Meningioma located near pituitary gland - true meningioma in the pituitary gland is rare but located around/above the gland is not uncommon. Definitive diagnosis requires tissue sample. Cause deficits by compressing on local structures. Effects of radiation may not be seen for some months so these are not a good immediate approach to reduce compression. Termed extra-axial tumours since they are outside brain tissue and compress into it.


Primary brain tumour may be subdivided into primary and more common secondary brain tumours. Primary brain tumours (astrocytoma, craniopharyngioma, glioma, ependymoma, neuroglioma, oligodendroglioma, glioblastoma multiforme, meningioma, medulloblastoma) arise from uncontrolled proliferation of cells within the brain. Secondary brain tumours occur from spread of cancer into brain from distant cancerous organ (metastasis). Common symptoms are headache, nausea, vomiting, seizures, a change in mentation, neurologic symptoms and loss of memory. Neurologic symptoms - can be variable. Numbness, tingling, hyperesthesia (increased sensitivity), paralysis, localised weakness, dysarthia (difficult speech), aphasia (inability to speak), dysphagia (difficulty swallowing), diplopia (double vision), amaurosis fugax (temporary loss of vision in one eye - Transient Ischaemic Attack), difficulty walking, inco-ordination, tremor, seizures, confusion, lethargy, dementia, delirium, and coma. All these can be symptoms of stroke.