Meningioma - Early Signs, Risk Factors, Diagnosis, and Treatment Explained

Overview: What Is Meningioma?

Meningioma is a type of brain tumor that develops in the meninges, the thin layers of tissue that cover the brain and spinal cord. Unlike most brain tumors, meningiomas are usually benign (noncancerous), but because they grow inside the skull, they can still press against the brain or spinal cord and cause serious health problems.

Meningiomas are the most common type of primary brain tumor in adults, accounting for about one-third of all brain tumors. They can occur at any age, but they are most often found in people between 40 and 70 years old, and women are affected more than men.

While many meningiomas grow slowly and may not need immediate treatment, others can be aggressive or recur after treatment. Early detection matters because timely diagnosis can prevent complications like seizures, vision problems, or memory loss.

What Are the Types of Meningioma?

Doctors classify meningiomas based on how they look under a microscope and how aggressively they grow. The World Health Organization (WHO) grades meningiomas into three main types:

• Grade I (Benign Meningioma): The most common type (about 80% of cases). Grows slowly and is usually noncancerous. Often curable with surgery.
• Grade II (Atypical Meningioma): Accounts for about 15–20% of meningiomas. Grows faster than Grade I tumors. Has a higher chance of coming back after treatment.
• Grade III (Anaplastic or Malignant Meningioma): Rare (about 1–3% of cases). Grows quickly and can spread to other parts of the brain or body. Requires aggressive treatment.

What Are the Causes of Meningioma?

The exact cause of meningioma is not fully understood, but doctors believe it develops when mutations occur in the DNA of cells in the meninges. These changes cause the cells to multiply uncontrollably, forming a tumor.

Some meningiomas also show changes in specific genes such as NF2 (neurofibromin 2). Exposure to radiation, especially during childhood, may also play a role in tumor development.

What Are the Risk Factors of Meningioma?

Certain factors increase the chances of developing a meningioma:

• Age: More common in people over 40.
• Gender: Women are about twice as likely as men to develop meningiomas.
• Hormones: Female hormones such as estrogen and progesterone may influence tumor growth, especially during pregnancy.
• Radiation exposure: Past radiation therapy to the head, even for benign conditions, increases risk.
• Genetic conditions: People with neurofibromatosis type 2 (NF2) are more prone to developing meningiomas.
• Family history: Rare, but some families have a higher risk.

What Are the Symptoms of Meningioma?

Because meningiomas grow slowly, symptoms often appear gradually. The signs depend on the size and location of the tumor.

Common early symptoms include:

• Persistent headaches
• Seizures
• Changes in vision (double vision, blurred vision)
• Hearing loss or ringing in the ears
• Difficulty with concentration or memory

Advanced symptoms may include:

• Weakness or numbness in arms or legs
• Balance or coordination problems
• Personality changes
• Speech difficulties
• Confusion or disorientation

Sometimes, meningiomas are discovered by accident during brain scans for unrelated issues, since small tumors may not cause any symptoms.

How is Meningioma Diagnosed?

If a doctor suspects a meningioma, several tests can help confirm the diagnosis:

• Neurological exam: A doctor performs a thorough neurological exam to assess your reflexes, muscle strength, coordination, vision, hearing, and balance.
• MRI Scan: Magnetic Resonance Imaging is a primary tool for detecting meningiomas, as it provides detailed cross-sectional images of the brain. An MRI can help determine the tumor's size and location.
• CT Scan: Computed Tomography uses X-rays to create images of the brain. A special dye may be injected beforehand to highlight abnormal tissue.
• Biopsy: If a meningioma is suspected or found, a piece of the tumor tissue is removed during surgery. A neuropathologist then examines this tissue to confirm the tumor's presence and growth rate, determine the grade of the meningioma, which indicates how aggressive and fast-growing the cells are.

Staging of Meningioma

Unlike other cancers, meningiomas are not usually staged (since they rarely spread outside the brain), but they are graded based on their growth pattern and aggressiveness.

• Grade I (Benign): Slow-growing, less likely to recur.
• Grade II (Atypical): Faster-growing, moderate chance of recurrence.
• Grade III (Anaplastic): Aggressive, high recurrence, may spread.

The grade helps doctors decide on the best treatment plan.

What Are the Treatment Options for Meningioma?

The choice of treatment depends on tumor size, location, grade, symptoms, and overall health of the patient.

• Surgery: This is the preferred treatment for many meningiomas, with the goal of completely removing the tumor to prevent its return. It involves carefully removing the tumor while trying to preserve surrounding brain tissue. However, surgery can be complex and may not be possible for tumors in challenging locations.
• Radiation Therapy: Used when surgery is not possible or when tumors recur. Radiosurgery, like Gamma Knife and CyberKnife, delivers a precise, high dose of radiation to the tumor, sparing surrounding healthy tissue. This is a good option for tumors in difficult-to-reach locations or those that have recurred. Intensity-modulated radiation therapy (IMRT) uses computer software to adjust the radiation intensity to the tumor, potentially reducing damage to nearby brain structures.
• Medical Treatments: While less common, medical treatments can be used for meningiomas that are inoperable or have recurred. Targeted agents and immunotherapy are areas of ongoing research and are being investigated in clinical trials for their potential to treat meningiomas.

Proton Therapy: When Is It Applicable?

Proton therapy is a type of radiation therapy that uses protons instead of X-rays. It is more precise and may reduce damage to surrounding brain tissue, making it useful for children or tumors in sensitive brain areas.

Meningiomas, particularly those in the skull base and near sensitive structures like the optic nerves, brainstem, and brain, often benefit from proton therapy's ability to protect nearby healthy tissue from radiation damage. By sparing healthy brain tissue, proton therapy reduces the risk of both short-term and long-term side effects, helping to preserve the patient's quality of life.

What Is the Prognosis for Meningioma?

The outlook depends on the tumor grade, size, and whether it was completely removed.

• Grade I meningiomas: 80–90% 10-year survival rate if fully removed.
• Grade II meningiomas: 50–70% chance of recurrence within 10 years.
• Grade III meningiomas: More aggressive, with a lower survival rate.

Other factors affecting prognosis include age, overall health, and response to treatment. Many people with benign meningiomas live normal lives after treatment.

Screening and Prevention of Meningioma

Currently, there are no standard screening tests for meningiomas. Most are found when symptoms appear or incidentally during brain imaging.

Prevention strategies include:

• Avoid unnecessary radiation exposure.
• Maintain a healthy weight.
• Manage chronic conditions like high blood pressure and diabetes.
• Regular check-ups if you have a genetic condition like NF2.

For International Patients

People from around the world come to Apollo Hospitals for the treatment of meningiomas. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling
  • Pre-arrival medical review of reports and imaging.
• Travel and logistics
  • Assistance with visa invitation letters, airport transfers, and nearby accommodation options.
  • Dedicated international patient coordinators to guide through each step.
• Language and cultural support
  • Interpreter services in multiple languages.
  • Clear, simple explanations at every stage with written care plans.
• Financial coordination
  • Transparent treatment estimates and packages when possible.
  • Support with international payment methods and insurance coordination.
• Continuity of care
  • Shared records, imaging, and treatment summaries for home doctors.
  • Telemedicine follow-ups for convenience after returning home.

Frequently Asked Questions (FAQs)

1. What is the survival rate for meningioma?

Most Grade I meningiomas have an excellent survival rate, with up to 90% of patients living 10 years or more after treatment. Higher-grade meningiomas have lower survival rates due to recurrence and aggressiveness.

2. What are the treatment side effects?

Surgery may cause temporary weakness, numbness, or speech problems. Radiation can cause fatigue, hair loss in the treated area, and rarely, memory issues. Side effects depend on tumor location and treatment type.

3. Can meningioma come back after treatment?

Yes. Benign meningiomas may recur in up to 20% of cases, while atypical and malignant meningiomas recur more frequently. Regular follow-up scans are essential.

4. How long is recovery after surgery?

Recovery time varies from a few weeks to a few months, depending on the tumor’s location and the patient’s overall health. Rehabilitation (physical therapy, speech therapy) may be required.

5. Can meningiomas be cured?

Many Grade I tumors are completely treated with surgery. For higher-grade tumors, treatment aims to control growth and manage symptoms rather than cure.

6. What is the cost of meningioma treatment in India?

Costs vary depending on type, hospital, and treatment plan. At Apollo, costs are significantly lower compared to the US or Europe, while maintaining international standards.

7. Is it safe to travel after meningioma treatment?

Most patients can travel after recovery, but it is best to consult your doctor before flying, especially soon after brain surgery.