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Meningioma

Meningiomas are tumours that start in the layers of tissue (meninges) that cover the brain and spinal cord. Most meningiomas are 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. But they are more common in the cerebrum and cerebellum. 

Symptoms of meningioma depend on where the tumour is in the brain. Symptoms include:

  • seizures (fits)
  • weakness
  • loss of eyesight
  • hearing loss

Types 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).

Most meningiomas are low grade (grade 1) or atypical (grade 2). They can also be malignant (grade 3) but this is rare.

How common it is

Around 21 out of every 100 brain tumours (21%) diagnosed in England between 2006 and 2010 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.

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.

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 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.

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.

Last reviewed: 
30 Oct 2019
  • Cancer: Principles & Practice of Oncology (10th edition)
    VT DeVita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

  • Incidence statistics from Cancer Research UK (Cancer Stats)
    Accessed August 2019

  • Brain tumours (primary) and brain metastases in adults
    The National Institute for Health and Care Excellence (NICE), July 2018

  • EANO guidelines for the diagnosis and treatment of meningiomas
    R Goldbrunner and others
    Lancet, 2016. Vol 17, Page 383-391

  • Clinical Commissioning Policy: Stereotactic Radiosurgery/Radiotherapy for Meningioma
    NHS England, 2013

  • The 2016 World Health Organisation Classification of Tumors of the Central Nervous System: a summary
    DN Louis and others
    Acta Neuropathologica, 2016. Vol 131, Issue 6, Pages 803-820

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