Meningioma

A meningioma is a brain tumour which develops within the meninges of the brain (the layer of tissue that covers the brain). It is the most common typically benign intracranial tumour. Although typically benign (not cancerous) and slow growing, they can cause a problem if they involve or compress nerves or brain tissue.

The World Health Organisation (WHO) classification scheme recognises 15 variations of meningiomas according to cell type. These variations are organised into three grades that generally reflect the rate of growth and likelihood of recurrence:

  • Grade 1: meningiomas which are slow-growing with a low potential to spread (benign meningiomas). These are by far the most common.
  • Grade 2: tumours that are faster spreading and more likely to return after treatment (atypical meningiomas)
  • Grade 3: the most uncommon meningiomas which are malignant, fast growing and have a higher chance of returning after treatment than atypical meningiomas (malignant meningiomas).

Symptoms

Some meninges tumours do not cause any obvious symptoms and are found during tests for other conditions. These are asymptomatic. Other meningiomas cause symptoms related to the area of brain or nerves affected. Some of the most common symptoms can be:

  • headaches (these may be more severe in the morning or wake you at night);
  • nausea and vomiting;
  • seizures;
  • limb weakness and poor coordination;
  • confusion and disorientation;
  • personality changes;
  • difficulty with speech;
  • visual loss and double vision;
  • hearing loss or disturbance such as tinnitus;
  • facial numbness or tingling;
  • difficulty swallowing;
  • loss of balance or dizziness.

Treatment

There are a number of different treatments for meningiomas. Many different factors are taken into account when considering the treatment options. These include:

  • the location;
  • the type and grade of the tumour;
  • your general health and level of fitness.

Initial diagnosis of a presumed meningioma is usually by CT or MRI scan. These tests can usually help identify the precise location and size of the tumour.

As meningiomas are often slow-growing, only increasing in size by 1-2mm per year, there may be no need for any immediate treatment. Instead regular monitoring and observation with surveillance imaging may be recommended particularly for asymptomatic small presumed meningiomas. 

Depending on the size and location of the meningioma, and the impact it is having on the patient’s life, surgery, radiotherapy or radiosurgery may be recommended. Sometimes a combination of these treatments is indicated. Steroids are often used to reduce swelling caused by the tumour during the peri-operative period. Anti-epileptic medication may be used for seizures.