Meningioma

What is a meningioma?

A meningioma is a type of tumor that grows from the protective layers of tissue that wrap around your brain and spinal cord. They usually are very slow-growing, often changing by just a few millimeters a year. Instead of digging into the brain itself, they typically just press gently against the outside of it as they grow.

Meningiomas are classified by WHO grade:

• Grade 1 (benign): this accounts for about 8 out of 10 cases. These are non-cancerous, grow very slowly, and often stay the exact same size for years or even decades without needing any treatment at all.

• Grade 2 (atypical): making up about 15% to 20% of cases, these grow a bit faster and are more likely to return if removed, sometimes requiring extra treatment like radiation after surgery.

• Grade 3 (malignant): this type is very rare, making up less than 3% of cases. They behave aggressively, can grow into the nearby brain tissue, and require immediate medical attention.

Where the tumor is located inside your head depends entirely on luck, and its position is what determines whether it causes symptoms (like headaches or vision changes) and how easy it is for a doctor to reach.

Symptoms of a meningioma

Many meningiomas cause no symptoms and are discovered incidentally on MRI. When symptoms occur they develop gradually and reflect the size and location of the tumour and its effect on adjacent structures:

• Headaches, often progressive and worse in the morning or when lying down

• Seizures, particularly in tumours involving the cerebral cortex

• Visual disturbances including blurred vision, double vision, or visual field loss from tumours near the optic pathways or cavernous sinus

• Weakness or numbness on one side of the body from tumours compressing the motor or sensory cortex

• Speech or language difficulties from dominant hemisphere tumours

• Personality or cognitive changes from frontal lobe compression

• Hearing loss or tinnitus from posterior fossa or cerebellopontine angle meningiomas

• Spinal cord or nerve root compression symptoms from spinal meningiomas

What causes meningioma?

The exact cause is not fully understood in most cases. Contributing factors include:

• Prior radiation to the head: the most clearly established environmental cause. Radiation-induced meningiomas typically develop 15 to 20 years after exposure and tend to be more aggressive than sporadic tumours.

• Female sex and hormonal factors: meningiomas are approximately twice as common in women as in men and express progesterone and estrogen receptors. They frequently grow during pregnancy and may enlarge with hormonal therapies.

• Genetic conditions: neurofibromatosis type 2 is the most important genetic cause, associated with multiple meningiomas alongside schwannomas and other CNS tumours. Other genetic mutations including in NF2, TRAF7, AKT1, and SMO genes are identified in sporadic meningiomas.

• Age: meningiomas are rare in children and adolescents, with incidence rising progressively from the fourth decade onwards.

• Obesity: it is associated with modestly increased meningioma risk through mechanisms that are not fully understood.

Meningiomas are detected through brain or spinal MRI, with blood tests playing a supporting role in relevant hormonal and systemic contexts.

Brain and spinal MRI Elfcare’s full-body MRI easily spots meningiomas, which are common, usually harmless lumps growing on the protective lining outside the brain. The scan usually allows doctors to identify a meningioma with high confidence based on its characteristic appearance, while also showing its size and location. Finding one unexpectedly simply allows you to start a safe plan to monitor it over time, typically avoiding any immediate treatment.

Blood tests cannot detect meningiomas but provide relevant hormonal and systemic context. Relevant markers in Elfcare's panel include:

• Estradiol and progesterone: assess hormonal context relevant to hormone receptor-positive meningiomas, which may be influenced by hormonal status and HRT use

• LH and FSH: provide menopausal status context relevant to hormonal influence on meningioma behaviour

• CRP: reflects systemic inflammation relevant to post-surgical assessment and general health context

• Full blood count: provides baseline systemic health assessment relevant to surgical planning if intervention is being considered

• HbA1c and glucose: metabolic health assessment relevant to surgical risk and overall health context

Why early detection matters

The vast majority of meningiomas grow slowly, and for small asymptomatic tumours identified early, the management approach is typically surveillance with serial MRI rather than immediate surgery. This approach, only possible when the tumour is identified before it causes significant neurological compromise, avoids the risks of surgery while monitoring for any clinically significant growth. When intervention eventually becomes necessary, surgery on a small meningioma that has been monitored and planned electively carries significantly lower risk than emergency surgery on a large tumour causing acute neurological deterioration. For the smaller proportion of higher-grade meningiomas, early identification before significant brain invasion or oedema has occurred allows for surgical removal with cleaner margins and better long-term outcomes.

How Elfcare can help

Elfcare's full body MRI includes comprehensive brain imaging that can identify meningiomas and characterise their size and location. Meningioma is one of the most commonly identified and clinically meaningful incidental findings on brain MRI, providing a structural diagnosis that changes how symptoms are understood and managed, or providing reassurance and a monitoring plan for an entirely asymptomatic finding.

Our blood panel covers hormonal markers relevant to meningioma behaviour and baseline systemic health relevant to management planning.

If our MRI identifies a meningioma, we take care of further diagnostics or refer you to the appropriate specialist.