Incidentally Discovered Meningiomas

Although meningiomas account for more 30 percent of all brain tumors, they are not always detected right away because of their slow-growing nature. Patients today undergo diagnostic procedures for a myriad of diseases and complaints. As a result, asymptomatic brain tumors, that were previously undetected, are found.

As a major referral center in the tri-state area for meningiomas and other brain lesions, the Department of Neurosurgery at The Mount Sinai Hospital is accustomed to dealing with these growths that are found incidentally.

Diagnosing a Meningioma

Most meningiomas are diagnosed using non-invasive imaging techniques such as:

  • Magnetic Resonance Imaging (MRI) Scan: An MRI scan uses magnetic waves to allow doctors to see two-dimensional and three-dimensional pictures of the brain and spine. The machine uses a magnet, radio waves, a computer, and, occasionally, a contrast dye injected into the patient to create the detailed pictures.
  • CT Scan: A CT scan is a type of X-ray which doctors use to see two-dimensional pictures of the brain and spine. Contrast dye is sometimes used to distinguish tumors.

How Are Meningiomas Discovered Incidentally?

Meningiomas are often diagnosed when a physician orders an MRI or CT scan to evaluate patients for unrelated symptoms or conditions, such as:

  • Headaches
  • Vertigo
  • Sinusitis
  • Head trauma following a car accident
  • Seizures
  • Psychiatric issues
  • Visual disturbances
  • Focal weakness or nerve disturbances
  • After a fall

“A patient might come in with hearing loss or dizziness. Following an MRI, we might discover that everything is fine in the ear, but there is a meningioma present in the frontal part of the brain,” said Joshua Bederson, MD, Chairman of the Department of Neurosurgery at The Mount Sinai Hospital.

Although many meningiomas are found incidentally, convexity and frontal meningiomas are more likely to be found through routine diagnostic tests for unrelated complaints than other types.

This incidental detection of a meningioma may help guide treatment decisions by offering neurosurgeons the opportunity to diagnose and manage the meningioma before symptoms occur.

Treatments for Incidentally Discovered Meningiomas

The treatment options for meningiomas, whether they are found incidentally or not, remain the same. The neurosurgeon will recommend a conservative approach of monitoring smaller meningiomas through scans performed several times a year.

Larger meningiomas may be resected using traditional approaches, such as a craniotomy or a skull-based surgery, or minimally invasive procedures like transnasal endoscopic surgery.

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