Meningioma is a common type of benign brain tumor that can sometimes affect pregnant women dramatically by growing at a rapid pace. According to a new study published in Neurosurgery journal, this sudden growth likely results from the ‘hemodynamic changes’ related to pregnancy.
These tumors originate from the membrane-line structures surrounding the spinal cord and the brain, referred to as meninges. The tumors are slow-growing, but instances of malignancy can result due to hormonal changes during pregnancy. Only a minor percentage of meningiomas occur in the spinal cord; the majority of them occur intracranially in various locations of the brain.
Females are more likely to suffer from this condition and predominance of meningioma in females and accelerated growth during pregnancy as well as the luteal phase of menstrual cycle is associated with receptors that trigger the tumor.
Another cause highlighting the growth of the tumor during pregnancy is ‘sex hormones’. Growth of meningiomas include the predilection of the tumors for females and the case that they may become more symptomatic or grow larger than normal during the third trimester of pregnancy, which suggests that ‘sex hormones’ may have a role to play in the development of this tumor.
The symptoms of this condition depends on the location of the tumor, but they mostly develop from compression of surrounding neurovascular structures in the brain. A meningioma tumor compressing the region of the cerebral cortex that allows for the movement of the neck, trunk, arm, face and leg on the opposite side of the body may result in motor weakness of the opposite half of a pregnant woman’s body.
The symptoms of nausea, vomiting and headache are often encountered during pregnancy. These may add to the confusion when it comes to evaluating the central nervous system in patients suffering from meningioma.
Symptoms that result in increased intracranial pressure, such as visual disturbances, may paint a similar picture as intracranial meningioma. Therefore, women suffering worsening neurological symptoms in the last few months of pregnancy regardless of the presence of focal signs should be considered for intracranial pathology.
Treatment options for pregnant women
The management of intracranial tumors in pregnancy is dependent on the physical condition of the patient, gestational age, tumor location, and other similar factors associated with pregnancy. Patients can pursue the following treatment options:
Radiation therapy: The main aim of this treatment is to kill meningioma tumor cells while avoiding the damage to the surrounding tissue of the brain. Radiation therapy involves positioning high-energy X-rays at the tumor site, and the variation and frequency of the beam is kept low because of pregnancy. Radiation therapy can also be pursued by patients who have undergone surgery before pregnancy; this form of treatment is referred to as adjuvant radiotherapy.
Surgery: Information about meningioma surgery from Skull Base Institute reveals that meningioma tumors can be safely removed. Patients with meningioma at the base of the skull were previously difficult to treat, but the development of highly specialized and sophisticated intraoperative monitoring equipment along with invasive surgical instruments have enabled specialists to treat hard-to-reach areas without causing disturbance in surrounding neurovascular structures.
Wait and see: this approach is a reasonable choice for patients with a small meningioma. Patients can have frequent neuroimaging scans and see if the tumor is not growing and can be successfully treated with medication.