Meningiomas are a type of brain tumour. A meningioma is a tumour that starts in the meninges. The meninges are layers of tissue (membranes) that cover and protect the brain and the spinal cord. There are three layers:
- the dura mater
- the arachnoid
- the pia mater (see diagram).
Most meningiomas are slow growing tumours, although some can be faster growing.
This information is about meningioma in adults. For more information about meningioma in children, contact the Children’s Cancer and Leukaemia Group.
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As a tumour grows, it can press on or grow into nearby areas of the brain. This can cause symptoms because it stops that part of the brain from working normally. Some symptoms can also happen because the tumour causes a build-up of pressure inside the skull. This is called raised intracranial pressure.
Symptoms can depend on the size and position of the tumour and how slowly or quickly it grows. They may develop suddenly or slowly, over months or years.
Meningiomas usually grow slowly. They may not cause any obvious symptoms and are often found during tests for something else. Tumours which are not causing symptoms may not need any treatment.
Possible symptoms include:
- sickness (vomiting)
- changes in personality
- being confused
- weakness in an arm or leg
- problems with balance
- seizures (fits)
- problems with sight.
We have more information about possible symptoms of a brain tumour.
The cause of meningiomas is unknown, but research is being done to find out more.
Meningiomas make up nearly a quarter (25%) of all primary brain and spinal cord tumours in adults in the UK. They are more common in women and usually affect people over the age of 35.
People who had previous radiation to the head have an increased risk of developing meningiomas. People who have a genetic (hereditary) condition called type II neurofibromatosis also have an increased risk.
Your doctors need to find out as much as possible about the type, position and size of the tumour so they can plan your treatment.
You may also have an angiogram. This is a test to check the blood vessels in the brain that supply the tumour. This can be done with a CT or MRI scan. Or you can have an injection of dye through a thin, flexible tube (catheter) that is inserted into an artery in your groin, arm or neck. After this you have a series of x-rays taken. Your nurse or doctor will explain this test in more detail.
Meningiomas can often be diagnosed only using scans. A biopsy is rarely needed.
Your doctor may also:
- check your reflexes and the power and feeling in your arms and legs
- shine a light at the back of your eye to check if there is swelling
- ask you some questions to check your reasoning and memory
- arrange for you to have blood tests to check your general health and to see how well your kidneys and liver are working.
Being diagnosed with a brain tumour can make you feel shocked, frightened, angry or upset. There is no right or wrong way to feel. Talking about your feelings can often help.
You may also want to get support from a brain tumour charity, such as:
How diagnosis affects your right to drive
Most people diagnosed with a brain tumour will not be allowed to drive for a time after their diagnosis. Your doctor, surgeon or specialist nurse will tell you if this applies to you.
If you have a driving licence, you must tell the licensing agency you have been diagnosed with a brain tumour.
You could be fined if you do not tell them. You could also be prosecuted if you have an accident.
Your doctor may talk about the grade of a tumour. The grade of a tumour describes how abnormal the cells look under a microscope. This can help your doctor understand how slowly or quickly the tumour may grow. They can use this information to help plan your treatment.
Most meningiomas are slow growing tumours. A slow growing tumour can still cause problems as it grows by pressing on surrounding tissue. But it is less likely than a faster growing tumour to grow into other parts of the brain. Meningiomas can be graded as 1, 2 or 3:
- Grade 1 meningiomas are the most common type. These tumours are slow growing. If all of the tumour is removed, they do not usually come back after treatment.
- Grade 2 meningiomas are sometimes called atypical tumours. They grow more quickly than grade 1 meningiomas. They may be more likely to come back after treatment.
- Grade 3 meningiomas are also called high-grade tumours. They usually grow more quickly. They are also more likely to come back after treatment.
- the size and position of the tumour
- the grade
- the symptoms you have.
A team of specialists will plan your treatment. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about the benefits and disadvantages of different treatment types. They will also explain the risks and side effects.
You may be given a choice of treatment options. You will have time to talk about this with your hospital team before you make any treatment decisions.
You will need to give permission (consent) for the hospital staff to give you the treatment. Ask any questions about anything you do not understand or feel worried about. Tell your specialist if you need more information or more time to decide on a treatment.
Active monitoring means regularly checking the tumour to find out if it is growing. Most meningiomas are very slow growing.
If the tumour is not causing you problems, your doctor may suggest delaying treatment until it is needed. This is because treatment can cause side effects and some of these may be permanent.
Instead of starting treatment, you may see your specialist doctor regularly to have scans to check for changes in the size of the tumour. They will also monitor your symptoms carefully. This can help your doctor know if and when to recommend treatment.
In some people the tumour grows so slowly that treatment is never needed.
Talk to your specialist doctor if you are worried about any symptoms. They will explain the benefits and risks of active monitoring.
If you need treatment, you are likely to have surgery to remove the tumour. Often this is the only treatment that is needed.
Radiotherapy uses high-energy rays to destroy the tumour cells.
You may have radiotherapy:
- after surgery, if the tumour cannot be completely removed
- after surgery for high-grade meningiomas, to reduce the chance of it coming back
- as your main treatment, if surgery is not possible.
A type of radiotherapy called stereotactic radiotherapy (SRT) can be used to treat meningioma.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy tumour cells. Meningiomas do not respond well to chemotherapy, so it is very rarely used.
Your specialist doctor or nurse will explain your treatment and possible side effects. Most side effects are short term and will improve gradually when the treatment is over. Some treatments can cause side effects that do not get better. These are called long-term effects. You may also get side effects that start may start months or years later. These are called late effects.
We have more information about coping:
Treatment for symptoms of meningioma
You may need treatment for the symptoms of a meningioma before you have any treatment for the tumour. You may also need your symptoms managed during your main treatment or for a while after it has finished.
You may have:
Clinical trials are medical research trials involving people. Doctors may use clinical trials to test new treatments, find new drugs, or improve the way treatments are given.
Because these tumours are rare, there may not always be a relevant clinical trial happening. If there is, your doctor or nurse may ask you to think about taking part.
They will give you information about the clinical trial so that you understand what it means to take part. If you decide not to take part in a trial, your specialist doctor and nurse will respect your decision. You do not have to give a reason for not taking part. Your decision will not change your care. Your doctor will give you the standard treatment for the type of tumour you have.
We have more information about clinical trials.
After your treatment has finished, you will have regular check-ups, tests and scans.
Some side effects can start months or years after treatment has finished. You can use your follow-up appointments to talk about these side effects, or about any other worries or problems you have.
Many people find they get very anxious before appointments. This is natural. It may help to get support from family, friends or a specialist nurse.