Meningioma

This is the most common type of tumor that forms in the head and may affect the brain. Find out about symptoms, diagnosis and treatment.

Update Date: 07.03.2026

Overview
Symptoms
Causes
Risk factors
Complications
Diagnosis
Treatment
Alternative medicine
Coping and support
Preparing for an appointment
Survival rates

Overview

A meningioma is a tumor that starts in the meninges. These are the thin layers that cover the brain and spinal cord. Although a meningioma does not start in brain tissue, it is classified as a primary brain tumor when it forms near the brain and as a spinal cord tumor when it forms near the spinal cord. This classification is based on its location within the central nervous system. Meningiomas make up about one-third of all primary brain tumors.

Most meningiomas grow slowly. Some cause no symptoms for many years. When they get bigger or sit near important areas, they can lead to serious health conditions.

Meningiomas happen more often in women and are found more often in older adults, but they can happen at any age.

Because many meningiomas grow slowly and cause few or no symptoms, treatment is not always needed right away. In some cases, careful monitoring with regular imaging is the best first step.

About 80% to 85% of meningiomas are benign. That means they are not cancerous. Many people do very well after diagnosis, especially when the tumor grows slowly and is monitored with regular scans.

Meninges

Three layers of membranes known as meninges protect the brain and spinal cord. The delicate inner layer is the pia mater. The middle layer is the arachnoid, a web-like structure filled with fluid that cushions the brain. The tough outer layer is called the dura mater.

Symptoms

Meningioma symptoms may not be noticeable. They're similar to other brain tumor symptoms and depend on where the tumor is located. When a meningioma grows in the brain, it can press on nearby tissue and cause certain symptoms.

Common symptoms may include:

  • Changes in vision, such as blurriness or double vision.
  • Numbness, tingling, pain or weakness on one side of the face.
  • Headaches that are worse in the morning or change over time.
  • Hearing loss or ringing in one ear.
  • Loss of smell.
  • Seizures.
  • Weakness or numbness in the arms or legs on one side of the body.

Thinking and mood symptoms may include:

  • Trouble with memory or confusion.
  • Trouble speaking or understanding words.
  • Personality or mood changes.

Rarely, a meningioma forms in the spine. Symptoms of meningiomas in the spine may include:

  • Numbness or tingling in the legs.
  • Weakness or trouble walking.
  • Trouble with bladder or bowel control.

What this means for you: Symptoms can be slow to start and vary based on where the tumor sits. Some people have few or no symptoms for a long time. If symptoms change or keep getting worse, your healthcare team can help figure out what's going on.

When to see a doctor

Most symptoms of a meningioma develop slowly, but sometimes the tumor needs care right away.

Often, meningiomas don't cause any symptoms that you notice and are found only on imaging scans done for other reasons.

Seek emergency care if you have:

  • A sudden seizure.
  • The most severe headache you've ever had.
  • Sudden changes in vision, speech or memory.
  • New weakness or numbness in the arms or legs.

Make an appointment with your healthcare professional if you have lasting symptoms that worry you, such as headaches that get worse over time. Even mild or vague symptoms should be checked early to rule out other causes and begin care if needed.

Causes

It isn't clear what causes a meningioma. Most people with meningioma don't have a clear cause or inherited condition. Experts know that something changes some cells in the meninges, making them multiply out of control and form a tumor.

What this means for you: Most of the time, there's no clear reason why the tumor started to grow. There isn't a single known cause.

Risk factors

Risk factors for a meningioma include:

  • Age. The risk rises with age and is highest in adults over 60.
  • Radiation exposure. Radiation therapy to the head, especially in childhood, increases risk.
  • Hormones. Meningiomas are more common in women, suggesting hormones such as estrogen and progesterone may play a role. Some studies link hormone replacement therapy, birth control pills and breast cancer with higher risk, but results vary.
  • Genetic conditions. A rare inherited disorder, neurofibromatosis type 2 (NF2), LINK raises the risk of developing multiple meningiomas and other nervous-system tumors.
  • Obesity. People with a high body mass index (BMI) may have a slightly higher risk, though the reason isn't clear.

Though some reports have suggested a possible link, current research has not found a clear or consistent connection between cellphone use and meningioma.

What this means for you: Most people with meningioma do not have a clear cause. Tell your care team if you had radiation to the head, take hormone-related medicines, or have a family history of NF2 so they can guide testing and follow-up.

Complications

A meningioma and its treatment can cause long-term complications. Treatment most often involves surgery and radiation therapy. Possible complications include:

  • Trouble focusing or paying attention.
  • Memory loss or slower thinking.
  • Personality or mood changes.
  • Seizures.
  • Weakness or trouble with balance.
  • Changes in vision, hearing or smell.
  • Trouble speaking or understanding language.
  • Fatigue or low energy.
  • Emotional changes, such as anxiety or depression.

Your care team can treat many of these issues or connect you with rehabilitation specialists, such as physical, occupational or speech therapists, to help improve recovery and quality of life.

Your healthcare professional can treat some complications and refer you to specialists to help you cope with other complications.

What this means for you: Many effects improve over time with rehabilitation, so ask about therapy options. Keep your MRI and follow-up visits, and don't stop medicines without medical advice. Consider safe supportive options such as meditation or gentle massage to help with stress and fatigue.

Diagnosis

A meningioma can be hard to diagnose because the tumor is often slow growing. Symptoms may be subtle and thought to be other health conditions or signs of aging. Many meningiomas are found by chance during brain imaging done for other reasons.

If your healthcare professional suspects a meningioma, you may be referred to a doctor who specializes in conditions of the brain and spine, called a neurologist.

Diagnosis usually starts with a review of your medical history and symptoms, followed by a physical and neurological exam. The doctor checks your vision, hearing, balance, coordination, strength and reflexes. If the exam suggests a concern, your care team orders imaging with contrast.

Imaging tests with contrast may include:

  • Brain MRI. This test uses magnetic fields and radio waves to make detailed pictures of the brain. It's the preferred imaging test for seeing a meningioma and how it affects nearby tissue.
  • Brain CT. This test uses X-rays to create cross-sectional images of the brain. An iodine-based contrast may be used to highlight certain areas, and CT is especially helpful for showing bone changes.

Sometimes, a biopsy is done to confirm the tumor type and grade. A biopsy isn't always needed because MRI findings can be enough to suggest a meningioma. When needed, a biopsy provides tissue for study under a microscope to confirm the diagnosis and grade.

Tumor histology and WHO grade

Histology means how the tumor cells look under a microscope. A biopsy allows the lab to study these cells and assign a grade based on the World Health Organization (WHO) classification system. Grade 1 cells look more organized and usually grow slowly. Grades 2 and 3 have more active or irregular cells that are more likely to come back after treatment.

Imaging can suggest a meningioma, but only a biopsy — looking at tumor cells under a microscope — can confirm the tumor type and grade. The pathology report helps predict how fast the tumor may grow and guides the care plan.

What this means for you: Histology and grade help the care team choose next steps. Many grade 1 tumors can be managed with surgery or observation. Grade 2 and 3 tumors are more likely to need added treatment, such as radiation, to lower the chance of the tumor returning. In some cases targeted therapies and clinical trials are an option.

Meningioma

This contrast-enhanced MRI scan of a person's head shows a meningioma. This meningioma has grown large enough to push down into the brain tissue.

Treatment

The goals of meningioma treatment are to control manage the tumor, protect neurological function and maintain quality of life. Decisions are based on what the tumor looks like on scans, the WHO grade from the lab, and your health and personal preferences. A team that may include specialists in neurology, neurosurgery, radiation oncology, neuroradiology and neuropathology works together to guide your care.

Meningiomas don't all need the same approach. Some can be safely watched, some are best treated with surgery first, and some benefit from radiation either instead of surgery or after it. Your care team reviews your MRI and biopsy results, talks through benefits and risks, and helps you choose the plan that fits your goals.

Meningioma treatment depends on several factors:

  • Tumor size and location.
  • Growth rate.
  • Age and overall health.
  • Personal goals for care.

These details help your care team decide whether the best approach is observation, surgery, radiation or a combination.

Wait-and-see approach

Not everyone needs treatment right away. A small, slow-growing meningioma that isn't causing symptoms may not need intervention.

This approach, known as observation or active surveillance, involves regular imaging and follow-up visits to watch for changes in the tumor or symptoms. If scans later show the tumor is growing or causing symptoms, your care team may recommend surgery or radiation.

Meningioma surgery and recovery

When the tumor causes symptoms or grows, surgery is often the first step. Surgeons remove as much tumor as safely possible.

After surgery:

  • If no tumor remains, follow-up scans are usually all that's needed.
  • If a small benign portion remains, observation or targeted radiation may follow.
  • If the tumor is irregular or cancerous, radiation is often added and targeted therapies along with clinical trials may be considered.

Surgery risks include bleeding or infection. Procedures near the optic nerve may affect vision.

Surgical approaches

Because meningiomas can grow in many parts of the brain and skull, surgeons use different approaches to reach and safely remove them. The goal is always to take out as much of the tumor as possible while protecting healthy tissue. Your team may use:

  • Craniotomy, where a small part of the skull is opened to reach the tumor.
  • Keyhole craniotomy, using a smaller opening for quicker recovery.
  • Endoscopic endonasal surgery, entering through the nose to reach certain skull base tumors.

Each technique has benefits and risks depending on the tumor's size and closeness to vital nerves or blood vessels.

Meningioma surgical treatment by location

Tumor location Treatment and outlook

Frontal lobe

Usually easier to reach. Full removal often leads to good recovery and low chance of coming back.

Bone near the eye, called the sphenoid wing

May need surgery plus focused radiation if full removal could affect vision. Treatment often controls growth while protecting vision.

Deep skull area near the brainstem, called the petroclival region

Complete removal may not be safe. Partial removal can lower the risk of nerve or brainstem injury and often controls growth.

Midline of the brain, called the parasagittal or falx

Surgeons remove as much as is safe while protecting blood flow. Careful surgery often leads to long-term control of tumor growth.

Outer surface of the brain, called the convexity

Often easy to reach. Surgery can usually remove the tumor completely, which often leads to good long-term control of tumor growth.

Spine or spinal cord

Often easy to reach. Surgery can often remove the tumor completely, leading to good long-term control of tumor growth.

Large veins in the brain, called the venous sinuses

Complete removal may not be safe. Partial removal plus radiation can control tumor growth.

Recovery from meningioma surgery is different for everyone. Healing can take weeks to months depending on size and location. Early movement, physical therapy and follow-up visits aid recovery.

Radiation treatment for meningioma

Radiation may follow surgery or serve as primary therapy when the tumor can't be safely removed. It destroys remaining cells, lowers recurrence risk, and can improve long-term survival.

Types of radiation used to treat meningioma may include:

  • Brain stereotactic radiosurgery (SRS). This radiation treatment delivers strong, focused radiation directly to the tumor. It's usually done in one session, so most people can go home the same day.
  • Fractionated stereotactic radiotherapy (SRT). This treatment delivers small doses of radiation over several sessions. It's often used for larger tumors or those near sensitive areas, such as the optic nerve.
  • Intensity-modulated radiation therapy (IMRT). This approach shapes and adjusts the radiation beams to match the tumor's outline, helping protect nearby healthy tissue.
  • Proton beam therapy. This method uses positively charged particles called protons to destroy tumor cells while reducing radiation exposure to surrounding tissue.

Medicines and targeted therapy

Medicines are sometimes used after surgery and radiation if any tumor cells remain or the tumor grows back. They're also considered when surgery or radiation isn't possible. Most meningiomas don't respond well to standard chemotherapy, so drug treatment is usually part of a clinical trial. Researchers are studying targeted drugs that act on tumor growth signals.

These are some of the medicines studied so far for meningioma:

  • Bevacizumab can reduce swelling and may slow tumor growth in some people, but results differ and more research is needed.
  • Bevacizumab plus everolimus has helped some tumors stay the same size in small studies, but it has not been shown to help people live longer.
  • Somatostatin-pathway drugs, such as octreotide, may keep the tumor from growing in some people, but the evidence is limited.
  • Tyrosine kinase inhibitors, such as sunitinib, have shown mixed results across small studies and are still considered experimental.
  • Immunotherapy, such as pembrolizumab, has been tried for high-grade tumors that come back, but early results are limited. It's best pursued in a clinical trial.

What this means for you: If the tumor grows after surgery and radiation, your care team may discuss clinical trials for targeted drugs or immunotherapy that match the tumor's biology.

Typical meningioma treatment paths

Tumor grade Typical treatment approach
Grade 1 Observation, surgery if needed, then follow-up imaging
Grade 2 Surgery, radiation, then regular MRI follow-up
Grade 3 Surgery, radiation, then ongoing monitoring or clinical trials

Alternative medicine

Alternative and complementary therapies don't treat meningioma tumors. But they can help with stress, sleep, pain, nausea and mood during or after treatment. They should be used alongside your medical care, not instead of it.

How it helps

There are many types of alternative medicine. Here's how each type may help:

  • Acupuncture. Can ease nausea, hot flashes or some types of pain.
  • Massage therapy. May reduce muscle tension and anxiety.
  • Meditation and relaxation exercises. Can lower stress and improve sleep.
  • Music therapy. May improve mood and help with coping.
  • Hypnosis. Sometimes used for anxiety, nausea or procedure-related stress.

Safety first

Tell your care team about any therapy you plan to try so they can check for safety with surgery, radiation or medicines. Avoid deep tissue massage over radiation areas or recent surgery sites.

Skip herbs or supplements unless your care team approves. Some can interact with medicines or affect bleeding risk.

When to avoid supportive therapies

If you have headaches that can't be controlled, new vision changes, new weakness or new seizures, seek medical care first.

Delay acupuncture or massage if you have low platelets, active infection or open wounds.

How to choose a practitioner

Look for licensed professionals who have experience with people who have brain or spine tumors. Ask them about their training, infection control, and how they coordinate with your care team.

What this means for you: Supportive care can make treatment more comfortable and daily life easier. Use these options to help manage side effects and stress. Check in with your care team to choose what's safe and helpful for you.

Coping and support

A meningioma diagnosis can disrupt your life. You have visits to doctors and surgeons as you prepare for your treatment. To help you cope, try to:

  • Learn all you can about meningiomas. Ask your healthcare team where you can learn more about meningiomas and your treatment options. Visit your local library and ask a librarian to help you find good sources of information, including online sources.

    Write down questions to ask at your next appointment with your healthcare professional. The more you know about your condition, the better able you'll be to decide about your treatment.

  • Build a support network. It can help to have someone to talk with about your feelings. Other people who can support you include social workers and psychologists. Ask your healthcare professional to refer you. Talk with your pastor, rabbi or other spiritual leader.

    It also can help to talk with other people with meningiomas. Think about joining a support group, either in person or online. Ask your healthcare team about brain tumor or meningioma support groups in your area. Or contact the American Brain Tumor Association.

  • Take care of yourself. Eat a diet rich in fruits and vegetables. Get moderate exercise daily if your healthcare professional OKs it. Get enough sleep to feel rested.

    Reduce stress in your life. Focus on what matters to you. These measures won't cure your meningioma. But they may help you feel better as you recover from surgery or help you cope during radiation therapy.

Preparing for an appointment

You can start by seeing your main healthcare professional. From there, you may be referred to specialists who treat brain conditions, such as neurologists and neurosurgeons.

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of any pre-appointment restrictions. When you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down any symptoms you have, including any that may seem unrelated to the reason for which you scheduled the appointment and when they began.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medicines, vitamins or supplements you take, including doses.
  • Take a family member or friend along, if possible. Someone who goes with you can help you remember the information you get.
  • Write down questions to ask your healthcare professional.

Preparing a list of questions will help you make the most of your time. For a meningioma, some basic questions to ask include:

  • Is my meningioma cancerous?
  • How large is my meningioma?
  • Is my meningioma growing? How quickly?
  • What treatments do you suggest?
  • Do I need treatment now? Or is it better to wait and see?
  • What are the potential complications of each treatment?
  • Are there long-term complications I should know about?
  • Should I seek a second opinion? Can you suggest a specialist or hospital that has experience in treating meningiomas?
  • Are there any brochures or other printed material that I can have? What websites do you suggest?
  • Do I need to decide about treatment right away? How long can I wait?

Be sure to ask all the questions you have.

Survival rates

A meningioma's outlook depends on its grade, size and location. The grade shows how fast the cells grow and how likely the tumor is to return. Age and overall health also affect long-term survival.

How a meningioma diagnosis can affect life expectancy

Many people live long lives after treatment. Grade 1 meningiomas are benign. They grow slowly and can often be fully removed.

Data shows that 97% of children and young adults and 86% of older adults are alive five years after diagnosis. Ten years after diagnosis, survival remains high — about 80% to 97% depending on age.

Survival rates by tumor grade

WHO Grade Typical behavior and outcomes
Grade 1 Grows slowly and is often cured with surgery; about 90% are alive 5 years after diagnosis.
Grade 2 Grows faster and returns more often; about 80% are alive at 5 years and about 66% at 10 years.
Grade 3 Rare and more aggressive; about 58% of people are alive 5 years after diagnosis, including about 66% of females and 47% of males.

What influences survival

Several factors shape survival with meningioma. Some can be improved with treatment choices, while others depend on the tumor itself. Factors can include:

  • How much tumor is removed. Complete removal gives the best long-term control. If only part can be removed, radiation helps keep it from growing again.
  • If the tumor can't be fully removed. Targeted radiation and regular MRI can control growth and maintain quality of life.
  • Radiation therapy for higher grades. For grade 2 and 3 tumors, radiation after surgery can extend life and lower the chance of recurrence.
  • Tumor location. Tumors near the skull base or optic nerve are harder to remove completely and more likely to return.
  • Tumor biology. Faster growing tumors with higher grades (2 or 3) tend to come back sooner.
  • Tumor site (brain vs. spine). Spinal meningiomas are often grade 1 and have excellent long-term survival after surgery.

Recurrence and follow-up

About 20% to 30% of grade 2 meningiomas and 70% to 80% of grade 3 meningiomas return within 10 years. Regular imaging and full removal lower that risk.

Follow-up imaging is key: MRIs every few months at first, then less often over time. If a tumor comes back, additional surgery or radiation can still provide many good years of life.

What this means for you: Most people with meningioma, especially grade 1, live many years without or after treatment. Higher grade tumors need closer monitoring and sometimes combined treatments. But outcomes continue to improve as surgery and radiation techniques advance.

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