Meningioma

Your brain and spinal cord have layers of protective tissue called meninges. Sometimes a tumor called a meningioma can grow in these tissues. This tumor slowly grows near the top and outer curve of your brain or the base of your skull. Typically not cancerous, meningiomas can grow large enough to cause problems or even be life-threatening if they press on important areas of your brain. That’s why we work to diagnose these tumors early, when treatment is most effective.

What to expect at your first visit

Meningiomas can cause different symptoms depending on their location. You may have headaches, dizziness, vision problems, seizures or paralysis (unable to move muscles). Some people also experience behavioral changes or cognitive difficulties (problems with learning, thinking and remembering).

During your first appointment, we’ll spend time asking you questions about your symptoms and also your medical history. We may also want to know if any other people in your family have had meningiomas. You can expect to have a neurological exam and a physical checkup, too. Your team will also likely have you do a number of tests.

Imaging tests

Imaging tests can create detailed images of your brain so we can see the size and location of tumors. Some tests also map the parts of your brain that do important functions, so we can avoid these areas when treating the tumor. These tests may include:

• Brain MRI.
• CT scan.

Biopsy

A neurosurgeon may do a biopsy to learn more about a brain tumor. They’ll remove a small tissue sample from the tumor. A neuropathologist (brain tissue specialist) in our lab will look at your sample under a microscope to figure out what kind of tumor you have, if it’s benign or malignant (cancerous) and how likely it’ll grow and spread (grade).

Meet Your Meningioma Team

If you choose Cleveland Clinic for meningioma diagnosis and treatment, you’ll have a team of experts across different specialties on your side. They’ll take a look at your tumor using leading-edge diagnostic technology and develop a highly personalized treatment plan based on your test results.

Depending on your needs, your care team could include:

• Neurologists.
• Radiologists.
• Neurosurgeons.
• Skull base surgeons.
• Physical therapists.
• Occupational therapists.
• Nurse practitioners.
• Physician assistants.

Your meningioma is unique to you — so your treatment will be, too. Your care plan will depend on your test results, age, health, lifestyle and goals. Your providers will work with you to create the best plan for your needs.

Observation

Small meningiomas that aren’t expected to grow or spread may not need treatment. Maybe you have no or slow-progressing symptoms. Or perhaps treatment could put your health and life at risk. If so, your providers may suggest a “wait-and-see” approach to see if there are any changes. They’ll do follow-up appointments to check in with you about your symptoms. And you’ll have regular brain MRIs to see if your tumor is growing or spreading.

Surgery

Most people with meningiomas will have surgery to remove the tumor (surgical resection). This is particularly true if your meningioma causes symptoms or is expected to start causing them. Our goal is to remove as much of the tumor as possible, if not all of it, as safely as possible. This depends on where your tumor is, if it’s connected to any brain tissue or veins and your overall health.

Our neurosurgeons can do both open and minimally invasive surgery to remove meningiomas. They specialize in endoscopic skull base surgery, using tiny incisions, a camera and special tools to access this delicate and hard-to-reach area of the brain. They can operate through your body’s natural openings like your nose, mouth or eye socket to minimize damage to delicate brain tissues.

Radiation therapy

We may recommend radiation therapy for meningiomas that are too deep or large to safely remove with surgery. We offer external beam radiation therapy and stereotactic radiosurgery (SRS), including Gamma Knife^® surgery.

Gamma Knife radiosurgery is a painless, minimally invasive procedure that doesn’t require any incisions or even a hospital stay. During a one- to two-hour treatment, we deliver powerful doses of radiation to the tumor from multiple angles. This radiation targets your tumor’s exact shape, reducing damage to nearby tissues. After treatment, you can return to your normal activities quickly, with minimal downtime.

Taking the Next Step

Learning you may have a brain tumor — even a benign one like a meningioma — can be a difficult diagnosis to hear. You’re likely worried and want fast, accurate answers about your condition. And you want the most effective treatment. Cleveland Clinic healthcare providers are standing by to help you through each step of your diagnosis, treatment and beyond. We’ll give you the education, support and innovative therapies you need — so you can look toward a hopeful future.