Meningiomas are brain tumors that represent a serious medical health condition that may cause permanent neurological deficits and psychological distress.
The Roland Study from 2024 revealed that Depo-Provera use for 1-year or more carries a 5.55 times the relative risk of meningioma when compared with non-exposed women.
The Petre study from 2018 determined that women exposed to Depo-Provera were at risk for the found PIK3CA mutation that has a tendency for skull based or multiple meningiomas.
The 2018 study from University of Colorado showed that women who continued Depo-Provera following meningioma resection tended to have a shorter progression-free survival for Grade I meningiomas compared to traditional oral contraceptives that combine estrogen with a progestin.
Multiple studies have confirmed that there are specific progestins that cause a dose-dependent increase in risk of meningiomas including the Mini-Pill
Pfizer has marketed this drug to women of lower socioeconomic status and to women across the world as a suitable medication for birth control despite these risks.
Meningiomas:
Meningiomas are the second most common intracranial tumor, and makes up 30% of all intracranial tumors, with an incidence of 4 out of every 100,000 people. Meningiomas are tumors of the meninges which is a tissue layer that covers the brain. Women are more affected than men and are most diagnosed between age 60-70. Most common symptom that brings a patient to get diagnostic imaging is a headache which is over 90% of patients or neurological deficits in over 75%. Other symptoms related to a meningioma at diagnosis include seizures (20%) or decreased level of consciousness (23%), and hemorrhage (6%). Incidental meningiomas are described between 3-4%, with no symptoms or signs related to the diagnosis. Mortality is most associated with surgery that is emergent and is 18x more than non-emergent surgery and 40x more in patients who suffer a post-operative hematoma. Initial symptoms generally depend on the location of the tumor and may be result of mass effect causing seizures or focal neurological deficits, headaches from elevated intracranial pressure, and loss of consciousness. Postoperative hematomas are more common with meningioma resection than other brain tumors. Infection in the post-operative period are more common in the emergency surgery group and is nearly 5x more common than what occurs in the elective surgical group. Post-operative hematoma increased the risk of neurological deterioration by 4x.[1]
Future Case:
Our physician life care planners can testify to all medical and non-medical care a woman will require as they age with neurological deficits caused by a meningioma and complications caused by the meningioma. This may require follow-up MRI, neurosurgical follow-up, shunt revision, seizure management, laboratory testing, radiation therapy, surgery, physical therapy, occupational therapy, speech therapy, neuropsychology, and other services.
[1] Utama, et al. Factors predicting complications, neurological deterioration and mortality for patients with meningioma surgery: An observation study. F1000Research 2022, 11:1104
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