Are new symptoms from return of tumor or dementia?

Dear Dr. Roach: My mother was diagnosed with right frontal lobe meningioma when she was 83. Surgery was successful — most of it was removed and found to be nonmalignant. The doctor told us he couldn’t remove it completely, and that it was a slow-growing type of tumor and wouldn’t return for about 20 years. Mom is now 100 and doing pretty well. She lives at home with caregivers. We notice normal signs of aging ... confusion, forgetfulness, lack of concentration and not much interest in TV or reading. Sometimes her behavior reminds us of the time shortly before she was diagnosed with the tumor back in 2004. Should we have an MRI of her brain done? If we find that the tumor has grown back and is putting pressure on her brain, what would you suggest? — J.A.L.

Dear J.A.L.: A meningioma is the most common and (usually) benign tumor of the brain. It’s a tumor of the meninges, the lining of the brain. These tumors cause problems by taking up space in the skull and compressing.

It is impossible to say without imaging whether her symptoms are due to the meningioma returning, or due to some other process.

If the tumor has regrown to the point where it seems likely it could be causing symptoms, there are other choices besides surgery. Radiation therapy can be effective. Without treatment, symptoms will likely slowly progress.

I would tend to recommend getting the CT or MRI, so you at least know what you are dealing with. If it isn’t the meningioma, she might benefit looking for other causes, such as medications, or from medication therapy for dementia.