Meningiomas: Clear Answers About the Most Common Brain Tumor
Most meningiomas are benign and slow-growing. Many are found by chance and simply watched. When one does need treatment, surgery can often remove it completely.
What Is a Meningioma?
A meningioma is a tumor that grows from the meninges, the layers of tissue that cover the brain and spinal cord. It is the most common primary brain tumor in adults. Because meningiomas grow from the brain’s covering rather than from the brain itself, they push on the brain rather than growing into it.
About 80% of meningiomas are benign (WHO grade 1). A smaller number are grade 2 (atypical), which tend to come back more often, and grade 3 meningiomas are rare and more aggressive. Meningiomas are more common in women and in older adults. Learn about meningiomas in the spine on our spinal meningioma page.
Symptoms
Many meningiomas cause no symptoms and are found on a scan done for another reason. When symptoms happen, they depend on where the tumor is:
Common symptoms
- Headaches that are new or gradually worsening
- Seizures
- Weakness or numbness in an arm or leg
- Vision changes or loss of vision
- Hearing loss or ringing in the ear
- Loss of smell
Symptoms patients often ignore
- Gradual personality changes, apathy or memory problems that family notices first
- Slowly worsening vision blamed on needing new glasses
- Changes in walking or bladder control in older adults
When it’s an emergency: A first seizure, a sudden severe headache, new weakness, confusion or sudden vision loss needs emergency care. Call 911 or go to the nearest emergency room.
Causes and Risk Factors
- Female sex and older age
- Prior radiation to the head
- Neurofibromatosis type 2 (NF2)
- Possible links to hormones; some meningiomas have hormone receptors
How We Diagnose Meningiomas
- Neurological exam: including vision, hearing, strength and thinking
- MRI with contrast: shows a well-defined tumor attached to the brain’s covering, often with a characteristic “dural tail”
- CT scan: shows calcium in the tumor and nearby bone changes
- Vision testing: for tumors near the optic nerves
Treatment Options
Observation
Small meningiomas that aren’t causing symptoms are often monitored with MRI scans every six to twelve months at first, then less often if they stay stable. Many never need treatment.
When surgery makes sense
Surgery is recommended for meningiomas that cause symptoms, are growing, or are large and pressing on the brain. For many meningiomas, surgery can remove the entire tumor and its attachment to the brain’s covering, which can often cure the problem. Surgery is performed through a craniotomy using image-guided navigation.
Radiation
Stereotactic radiosurgery (focused radiation) can control small meningiomas, tumors in hard-to-reach locations, or tumor left behind after surgery. Radiation is also used after surgery for higher-grade meningiomas.
Getting you to the right surgeon
Depending on a tumor’s type, size and location, surgery is sometimes best performed by a neurosurgeon who specializes in brain tumors. Dr. Grunch reviews your imaging and makes that decision with you: she will either perform your surgery herself or refer you to a trusted brain tumor specialist, so you get the right operation from the right surgeon.
Why Choose Dr. Betsy Grunch for Meningiomas
- Duke-trained: neurosurgical residency and spine research fellowship at Duke University School of Medicine, where she received the Spine Young Investigator Award
- Experience you can count on: in practice since 2013, performing 400 to 600 surgeries a year and more than 5,000 procedures over her career
- Comprehensive neurosurgical care: she treats conditions of the brain, spine and peripheral nerves, and works closely with oncology and radiation teams
- The right treatment for you: board-certified (FAANS, FACS, FCNS), she starts with the least invasive option that will work, and recommends surgery when it can correct the problem
- Clear answers: known online as Ladyspinedoc, she makes sure you understand your imaging and every option in front of you
What to Expect If You Need Surgery
Before surgery
You’ll meet with Dr. Grunch or one of her physician assistants to review your MRI and talk through the goals and risks of surgery. Additional imaging may be ordered to plan the safest approach.
Procedure day
Surgery typically takes several hours. Most patients spend a night in the intensive care unit for close monitoring, followed by a few days in the hospital.
Recovery timeline
- Days 1-4: close monitoring, walking and pain control
- Weeks 1-4: rest and gradual return to light activity; no driving until cleared
- Weeks 4-12: return to work and most activities for many patients
- Ongoing: follow-up MRI scans to watch for regrowth
Frequently Asked Questions
Is a meningioma cancer?
Most are not. About 80% are benign. A small number are atypical or malignant and need closer follow-up and sometimes radiation.
Does every meningioma need surgery?
No. Many small meningiomas are watched with regular MRI scans and never need treatment.
Can a meningioma come back?
It can, especially if part of the tumor couldn’t be removed or the tumor is higher grade. Follow-up MRI scans catch any regrowth early.
How fast do meningiomas grow?
Most grow slowly, often over years. Some don’t grow at all.
What is the recovery like?
Many patients return to normal activities within one to three months, depending on the tumor’s size and location.
Take the Next Step
Hearing that you have a brain tumor is frightening. Whether you need a diagnosis, a treatment plan or a second opinion, Dr. Grunch and the Southern Neurosurgery team are here to help you understand your options.
Call 470-293-9800 to schedule an appointment or contact us online.
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We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.
This page is for educational purposes only and is not a substitute for medical advice. If you have a sudden severe headache, a seizure, new weakness or numbness, confusion, or trouble speaking or seeing, call 911 or go to the nearest emergency room.