Meningioma

Meningiomas are tumours that start in the layers of tissue (meninges) that cover the brain and spinal cord. Most meningiomas are not cancerous (benign).

The meninges are membranes that support and protect the brain and spinal cord. A clear fluid called cerebrospinal fluid (CSF) travels in the spaces formed by the meninges.

Diagram showing the meninges, brain and spinal cord

Meningiomas can start anywhere in the brain and spinal cord.

Symptoms of meningioma depend on where the tumour is in the brain. Some meningiomas do not cause any symptoms. They might be picked up when you have a brain scan for something else.

If you have symptoms these might include:

fits (seizures)
weakness in your arms or legs
loss of eyesight
hearing loss

Types and grades of meningiomas

Doctors group meningiomas into groups depending on how quickly they are likely to grow. This is called the grade. They can be low grade (slow growing) or high grade (fast growing).

The grade depends on how the cells look. Generally, the more normal the cells look, the lower the grade. The more abnormal the cells look, the higher the grade. Grade also depends on genes and proteins in the tumour cells.

There are 3 grades of meningiomas:

grade 1
grade 2
grade 3

Doctors also split meningiomas into subtypes. There are 15 different types of meningioma.

How common it is

Around 27 out of every 100 brain tumours (around 27%) diagnosed in England between 1995 and 2017 were meningiomas. It is the most common type of benign brain tumour diagnosed in the UK.

Meningiomas are more common in women than in men.

What tests will I have?

You have tests to diagnose a meningioma. Your doctor checks the size of the tumour and its location. This helps your doctor plan your treatment. The tests you might have include:

MRI scan or CT scan
a biopsy
blood tests
a test of your neurological system (neurological examination)
a scan to look at the blood vessels in your brain (brain angiogram)

Treatment

Your treatment depends on whether the meningioma is low grade (slow growing) or high grade (fast growing). It also depends on where the tumour is.

Monitoring

For a low grade meningioma, your doctor might monitor you with regular MRI scans. This is called active monitoring. You then have treatment if there are signs that the tumour is growing.

Surgery

A highly specialised doctor (neurosurgeon) removes as much of the tumour as possible. Sometimes this is the only treatment you need. The exact type of surgery you have depends on where the tumour is.

It isn’t always possible to completely remove the tumour during the operation. Especially if the tumour is growing around important nerves or blood vessels. You might have more surgery if doctors couldn't remove all of the tumour. Or your doctor might suggest that you have radiotherapy.

Radiotherapy

Radiotherapy uses high energy x-rays to kill tumour cells. You might have radiotherapy:

to reduce the risk of the meningioma coming back, especially if the tumour is fast growing
if the tumour is in an area that is too difficult to operate (for example, the base of the skull)
if you can't have surgery for any reason
if the meningioma comes back

You may have a type of radiotherapy called stereotactic radiotherapy. It targets high doses of radiotherapy to the tumour. Doctors sometimes call this stereotactic radiosurgery, although it isn't a type of surgery.

Follow up

You have regular appointments with your doctor or nurse after treatment finishes. Your doctor examines you at each appointment. They ask how you are feeling, whether you have had any symptoms or side effects, and if you are worried about anything. You also have MRI scans on some visits.

How often you have check ups depends on your individual situation.

For a grade 1 meningioma, you might have an MRI scan every year, for up to 5 years. You then have an MRI scan every 2 years.

For a grade 2 meningioma, you might have an MRI scan every 6 to 12 months. After 5 years, you have an MRI scan every 2 years.

For a grade 3 meningioma, you might have an MRI scan every 3 to 6 months. After 2 years, you have an MRI scan every 6 to 12 months.

Coping with meningioma

Coping with a diagnosis of a brain tumour can be difficult, both practically and emotionally. It can be especially difficult when you have a rare tumour. Being well informed about the type of tumour you have, and its treatment can make it easier to cope.

Research and clinical trials

Doctors are always trying to improve the diagnosis and treatment of brain tumours. As part of your treatment, your doctor might ask you to take part in a clinical trial. This might be to test a new treatment or look at different combinations of existing treatments.