The Mount Sinai Hospital is a major referral destination for convexity meningiomas in the tri-state area, and our esteemed neurosurgeons specialize in treating complex cases, such as atypical, cancerous, and recurring tumors.
Convexity meningiomas are tumors that grow on the surface of the brain, known as the convexity. These account for approximately 20 percent of all meningioma cases. Convexity meningiomas differ from other types in that their location on the surface makes them most surgically accessible. Because complete resection is commonly possible, these tumors typically have a low recurrence rate. Rarely, some patients do have returning growths after the first tumor was removed.
The vast majority of convexity meningiomas are noncancerous, but in rare cases, they can be malignant. The World Health Organization classifies the benign tumors as Grade I (slow growth with distinct borders). Convexity meningiomas can also be present as atypical (Grade II) or malignant/cancerous (Grade III).
Convexity Meningioma Symptoms
Meningiomas are most commonly discovered incidentally, before a patient experiences any symptoms. The most common way a convexity meningioma is diagnosed is when a magnetic resonance imaging (MRI) or computed tomography (CT) scan is performed following an accident or when a patient presents with symptoms unrelated to the growth such as headache, hearing loss, dizziness, and vertigo, among other neurological deficits. The tumor will appear on the scan.
Typically, convexity meningiomas will not produce symptoms until reaching a relatively large size. However, certain locations on the convexity are more likely to produce symptoms, even when the tumor is small. In addition, some meningiomas, even those that are noncancerous, can invade the underlying brain and cause symptoms, even when they are small.
Symptoms can vary depending on the tumor’s size and location and can include:
- Headaches: A common symptom, headaches can result from a meningioma altering the pressure levels in the brain. They can range from mild to severe and can occur intermittently or continually. Headaches can be associated with nausea or vomiting and can limit a person’s ability to focus or concentrate.
- Seizures: Compression of the brain or swelling, as a result of growing or invasive meningiomas, can cause seizures and even epilepsy. Patients may experience involuntary muscle spasms or visual hallucinations as well as be confused or fatigued. The Mount Sinai Neurosurgery Department is studying the connection between epilepsy and meningiomas.
- Neurological deficits: Convexity meningiomas can develop near the motor and sensory areas of the brain, and small tumors can sometimes impact a patient’s coordination, feeling, or strength in the extremities. Typically, tumors pressing on one hemisphere of the brain cause symptoms on the opposite side of the body. For example, a meningioma exerting force on the right hemisphere can cause weakness or tingling in the left arm or leg. In addition, speaking difficulties (finding words and understanding language) can occur if pressure is applied to a particular area on the left hemisphere of the brain, which controls speech. Other neurological effects include memory and concentration trouble, unusual personality changes, and vision loss or double vision.
- Vertigo: Vertigo has been associated with small supra-tentorial convexity meningiomas.
- Syncope, or fainting: Convexity meningiomas can impact the cerebral blood flow, which can cause some people to faint.
Treatment for Convexity Meningiomas
Because of their location on the brain’s surface (as opposed to deep within the brain), convexity meningiomas are typically easier to treat than other types of meningiomas. The Mount Sinai Hospital offers the full range of treatment options for convexity meningiomas. Our multidisciplinary team assesses each tumor’s size and location, among other factors, to determine the appropriate course of action, which can include:
- Surveillance: If the meningioma is small and produces no symptoms, then the doctor may recommend a “watchful waiting” approach, which involves regular MRI scans to monitor its growth.
- Surgery: If the tumor is symptomatic or growing and the patient is of an age in which surgery is appropriate, the neurosurgeon will typically recommend surgery to remove the meningioma. The Mount Sinai Hospital offers several surgical procedures, including craniotomy, minicraniotomy, and minimally invasive and image-guided treatments. If the meningioma is large and has a rich vascular supply, the doctor may prescribe a pre-surgery embolization.
- Stereotactic radiosurgery: For those patients in whom surgery is not advisable or the meningioma is unresectable, radiation therapy can be used to treat small incompletely removed tumors and certain tumor recurrences.
- Chemotherapy: In rare cases, such as the tumor being malignant, chemotherapy may be used.
Recovery Following Surgical Treatment for Convexity Meningiomas
Convexity meningioma patients are typically discharged from the hospital two to four days after surgery. Once home, patients can care for themselves and usually do not need a home attendant, a visiting nurse, or specialized home care. However, patients are advised not to drive or do their own errands for the first two weeks.
Patients will visit their neurosurgeon 7-14 days after being discharged to discuss progress and plans for increasing activity. Although heavy exercise is usually limited during the first two weeks, walking (up to 20 minutes three times a day) is strongly encouraged in order to avoid complications of inactivity and bed rest.
Patients respond differently to anesthesia and surgery. The range of time off from work depends not only on the patient’s response and recovery but also on the nature of their job, the length of their commute, and any underlying medical conditions. Most patients return to work between two and six weeks after their surgical procedure, but many can return sooner.
Rehabilitation may be beneficial in patients presenting with neurological deficits.
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From nausea to persistent headaches, the symptoms of a meningioma often depend on its size and location. Learn More
Our experienced neurosurgeons will evaluate your symptoms and will use imaging techniques to diagnosis your meningioma. Learn More