Meningiomas: Symptoms, Diagnosis, and Treatment Options

Meningiomas are the most common primary brain tumor in adults. They grow from the meninges — the protective layers of tissue that surround the brain and spinal cord — rather than from the brain itself. The great majority are benign (non-cancerous) and slow-growing, and many are found incidentally on scans done for other reasons.

What is a meningioma?

Because a meningioma grows from the covering of the brain, it usually pushes on the brain from the outside rather than growing within it. This often makes complete surgical removal possible when treatment is needed. Meningiomas are graded by how the cells appear under the microscope; most are WHO grade 1 (benign), while a smaller number are atypical (grade 2) or, rarely, malignant (grade 3).

Symptoms

Symptoms depend on the tumor’s size and location, and many small meningiomas cause none at all. When symptoms do occur, they may include:

• Headaches
• Seizures
• Weakness, numbness, or difficulty with coordination
• Changes in vision, hearing, or smell
• Memory or personality changes

Because these symptoms develop gradually, they are sometimes attributed to other causes before an MRI reveals the tumor.

How is it diagnosed?

Meningiomas are usually identified on an MRI, which shows the tumor’s size, location, and relationship to nearby structures. A CT scan may add information about the bone. The imaging appearance is often characteristic enough to make the diagnosis without a biopsy.

Treatment options

The right approach depends on the tumor’s size, location, growth, and whether it is causing symptoms:

• Observation. Many small, symptom-free meningiomas can simply be monitored with periodic MRIs, since some never need treatment.
• Surgery. When a meningioma is growing or causing symptoms, surgical removal is often the most effective treatment and can be curative for benign tumors. Modern minimally invasive (keyhole) and skull base techniques allow many meningiomas to be removed through smaller openings, protecting the brain, nerves, and blood vessels and often shortening recovery.
• Radiation therapy (including stereotactic radiosurgery). Used for tumors that are difficult to remove completely, for residual or recurrent tumors, or for patients who are not candidates for surgery.

Why experience matters

Meningiomas can occur in delicate locations — near the optic nerves, major blood vessels, or the skull base. Removing them safely while preserving function requires surgical expertise and careful planning. The goal is always to relieve pressure and control the tumor while protecting quality of life.

Dr. Arnaout has subspecialized training in skull base and minimally invasive neurosurgery and tailors the approach to each patient’s tumor.

When to see a specialist

If an MRI has identified a meningioma — whether or not it’s causing symptoms — an evaluation by a neurosurgeon experienced with these tumors can help you understand whether monitoring, surgery, or radiation is the best path.

To discuss a meningioma diagnosis or get a second opinion, request an appointment.