Meningiomas: Understanding Symptoms, Diagnosis & Treatment Options

What Are Meningiomas?

Meningiomas are tumours that arise from the meninges, the protective membranes that cover the brain and spinal cord. They are the most common primary intracranial tumour in adults, arising from the meningothelial (arachnoid cap) cells of the meninges.

Most meningiomas grow slowly and are benign (non-cancerous), but their location inside the skull means they can still press on the brain, spinal cord, or nearby nerves and cause symptoms. Meningiomas are typically intracranial extra-axial tumours, meaning they originate outside the brain tissue but within the skull cavity.

Are Meningiomas Cancer?

Most meningiomas are benign and do not spread to other parts of the body. However, they can still be serious because they grow in a confined space and can affect important brain functions.

A small proportion are atypical (borderline) or malignant (cancerous), which grow faster and have a higher chance of coming back after treatment. The WHO classifies meningiomas into three grades (Grade 1–3) based on histopathological and molecular features, including mitotic index and brain invasion.

Types of Meningiomas

Medical professionals classify meningiomas into three main grades based on their cellular appearance and behaviour:

• Grade 1 (Benign): ~80% of cases, slow-growing, lowest recurrence risk (5–7% at 10 years after complete resection).
• Grade 2 (Atypical): Faster growth, abnormal cells, higher risk of coming back.
• Grade 3 (Malignant): Fastest growing, very abnormal cells, highest recurrence rate.

According to StatPearls (2024) and CBTRUS 2023 data, meningiomas represent approximately 39% of all primary central nervous system tumours. And around 50% of benign brain tumours, with nearly 80% classified as WHO Grade 1. Higher-grade tumours have significantly higher recurrence rates, with 10-year recurrence rates rising from about 5–7% in Grade 1 to over 30–50% in Grade 3.

Where Do Meningiomas Occur in the Brain?

Meningiomas can develop at several key locations in the brain and spinal cord:

• Convexity meningiomas: On the brain’s outer surface
• Parasagittal meningiomas: Near the midline between both hemispheres
• Sphenoid wing meningiomas: At the skull base near the eyes
• Posterior fossa meningiomas: At the back of the brain
• Foramen magnum meningiomas: Where the brain meets the spinal cord

Symptoms of Meningiomas

Meningioma symptoms usually start slowly and get worse over time. Common signs include:

• Persistent or worsening headaches
• New-onset seizures
• Blurred or double vision
• Hearing loss or ringing in the ears
• Balance or coordination problems
• Memory issues, confusion, or poor focus
• Personality or behaviour changes
• Weakness or numbness in the face, arms, or legs

Causes & Risk Factors for Meningiomas

The exact causes of meningiomas are not fully known. Most develop sporadically without a clear trigger, though genetic changes in tumour cells are common and can be linked to more aggressive types. Some known risk factors include:

• Age 40–70 years
• Female sex (approximately 2–3 times more common than in men, possibly related to progesterone receptor expression in tumour cells)
• Previous radiation to the head or neck
• Genetic conditions like neurofibromatosis type 2
• Hormonal factors, particularly progesterone and estrogen receptor activity, are thought to influence tumour growth in some patients

How Meningiomas Are Diagnosed

Accurate meningioma diagnosis involves several systematic steps:

1. Medical history: Symptoms, duration, family history
2. Neurological exam: Reflexes, strength, balance, memory
3. MRI brain: MRI with contrast is the imaging modality of choice, typically showing a dural-based enhancing lesion with a characteristic "dural tail sign".
4. CT scan: Helpful for bone changes and calcification
5. Advanced imaging: In rare cases, MR spectroscopy and PET are recommended.
6. Biopsy/pathology: Confirms the type and grade of the tumour

Complications of Untreated Meningiomas

While many small meningiomas require only monitoring, larger untreated tumours can lead to serious complications:

• Worsening nerve problems as the tumour presses on the brain.
• Raised intracranial pressure may lead to headaches, nausea, vomiting, papilledema, and visual disturbances.
• New or worsening seizures.
• Memory decline, thinking, and concentration.
• Weakness, poor coordination, and difficulty with daily activities.

Meningioma Treatment Options

Meningioma treatment approaches vary based on tumour size, location, grade, and your overall health status:

• Surgery for symptomatic or growing tumours.
• Stereotactic radiosurgery (e.g., Gamma Knife or CyberKnife) is an effective option for small, residual, or surgically inaccessible meningiomas.
• External beam radiation for larger or partly removed tumours.
• Observation with scans for small, asymptomatic meningiomas.
• Chemotherapy has limited benefit and is generally reserved for high-grade (Grade 3) or refractory cases when surgery and radiotherapy are not possible.

When Is Surgery Needed?

Surgical intervention becomes necessary under specific circumstances:

• Tumours causing significant neurological symptoms or functional impairment.
• Rapidly growing meningiomas documented on serial imaging studies.
• Large tumours create dangerous pressure within the skull.
• Younger patients with substantial life expectancy ahead.
• Accessible tumour locations where complete removal is feasible.

When Is Observation Recommended?

Your medical team may recommend careful monitoring rather than immediate treatment when:

• Small tumours produce no symptoms or minimal symptoms.
• Advanced age, where surgical risks outweigh potential benefits.
• Significant medical conditions increase treatment complications.
• Slow-growing tumours in elderly patients with limited life expectancy.
• Patient preference after thorough discussion of risks and benefits.

Life After Meningioma Treatment

Life after meningioma treatment is often excellent, especially for completely resected Grade 1 tumours, though ongoing MRI surveillance is essential, and many people return to normal or near-normal routines, especially after small benign tumours. Some may have mild ongoing weakness, fatigue, or memory issues, so regular follow-up scans and rehabilitation help track recovery and detect any regrowth early.

Recovery Timeline & Rehabilitation

Post-treatment recovery follows predictable patterns:

• Initial recovery (1–2 weeks): Hospital stay, wound care, start moving.
• Short-term (1–3 months): Symptoms ease, and the daily routine slowly resumes.
• Long-term (3–12 months): Continued improvement; many get back to near-normal life.
• Rehabilitation: Physiotherapy, occupational, and speech therapy if needed.

Diet & Lifestyle Support for Patients

Supporting your recovery through healthy lifestyle choices enhances treatment outcomes:

• Eat a balanced diet with fruits, vegetables, lean proteins, and whole grains.
• Stay well hydrated.
• Do gentle, regular exercise as advised by your doctor.
• Manage stress with relaxation, meditation, or counselling.
• Prioritise good sleep to support healing and brain function.

Prognosis & Survival Rate

The outlook for most meningiomas is good, especially for benign (Grade 1) tumours that are fully removed. Many patients live for decades with excellent functional outcomes, particularly after complete resection of low-grade tumours.

Atypical and malignant meningiomas are more likely to come back and may need repeat surgery or radiation. Overall prognosis depends on tumour grade, how much was removed, your age, general health, and response to treatment.

When to Seek Emergency Care

Certain symptoms require immediate medical attention:

• Sudden severe headaches, unlike any previously experienced.
• Rapid onset of confusion, disorientation, or altered consciousness.
• New seizures or significant worsening of existing seizures.
• Sudden vision loss or severe visual disturbances.
• Acute weakness or numbness affecting one side of the body.

Conclusion

Living with a meningioma can feel overwhelming, but timely diagnosis, regular follow-up, and the right medical team make a big difference. Stay alert to new or worsening symptoms, keep your appointments, and discuss all treatment options with your doctor so you can make confident, informed decisions.

To support this journey, Metropolis Healthcare offers more than 4,000 tests, comprehensive full body checkups, and speciality testing that can aid in diagnosis, monitoring, and overall health assessment. You can book tests easily via the website or app and benefit from trusted home sample collection with quick turnaround times. The strong network of 10,000+ touchpoints helps you and your family access accurate reports and timely care with greater comfort and convenience.

FAQs

Are meningiomas life-threatening?

Most meningiomas are not life-threatening if found early and treated. They can become serious if they grow large, are high-grade, or press on vital brain areas.

Can meningiomas return after treatment?

Yes. Some meningiomas, especially atypical or malignant ones, can come back. Regular follow-up MRI scans are important.

What is the best treatment for meningiomas?

The best treatment depends on size, location, grade, and your health. Options include observation, surgery, radiation, or a combination.

How fast do meningiomas grow?

Most meningiomas grow slowly over the years. Atypical and malignant types may grow faster and need closer monitoring.

Do meningiomas affect memory and behaviour?

Yes. Tumours in the frontal or temporal lobes can cause changes in mood, personality, and memory, which may improve after treatment.

Can you live a normal life after meningioma surgery?

Many people return to normal or near-normal life after recovery. Some may need rehabilitation, medicines, and long-term follow-up.

References

• https://my.clevelandclinic.org/health/diseases/17858-meningioma
• https://www.mayoclinic.org/diseases-conditions/meningioma/symptoms-causes/syc-20355643
• https://pmc.ncbi.nlm.nih.gov/articles/PMC3358970/
• https://www.ncbi.nlm.nih.gov/books/NBK560538/