Diagnosis and treatment

Generally a CT scan or MRI scan is the first investigation people will have. This will show where the tumour is and how large it is. Meningiomas can have quite a distinct appearance on a scan but sometimes a biopsy will be needed. This is when a small amount of tissue is taken from the tumour and analysed under a microscope. A biopsy may be performed on its own or at the same time as a larger operation to remove the tumour.

If the meningioma isn’t causing any significant symptoms you will be monitored and given regular scans or scanned if your symptoms get worse. The ‘watch and wait’ option may also be preferable if the risks of the surgery outweigh the possible benefits.

Surgery to remove all or some of the tumour is the most common treatment. Surgery may not be possible if the tumour is in an area of the brain that is difficult to operate or if more problems will be caused by trying to remove it.

To remove the tumour the surgeon performs an operation called a craniotomy. A section of the bone is removed from the skull to allow the surgeon to remove the tumour, this is put back in place at the end of the operation. A small section of your hair will have to be shaved but the rest of you hair often covers this over. People stay in hospital for a week on average after the surgery. You may experience headaches and feel quite tired for a while afterwards but these should lessen with time.

You can read more about this operation in our Craniotomy fact sheet.

Radiotherapy


Meningiomas can also be treated with radiotherapy. This can be done with or without surgery. Sometimes you might be monitored after your surgery to see if the tumour is growing back before radiotherapy is considered.

The purpose of the radiotherapy is to shrink any remaining tumour or to stop/ slow down the rate at which is might grow back. Commonly, you will undergo treatment daily (called a fraction) for approximately 5-6 weeks, but each treatment only lasts a few minutes. Before the treatment starts, a mould will be made of you head. From the mould a clear Perspex or plastic mask will be made. You will wear the mask during treatment, it keeps you head still and in same position and enables marks to be made on shell instead of the skin to tell the radiographers where to direct the radiotherapy beams.

Side effects: Radiotherapy can make you feel quite tired and this may continue even after the treatment has stopped. You will experience some hair loss around the area which was treated and sometimes where the radiotherapy beams exit. The hair will grow back afterwards although it may not be as thick as it was before or it might be a slightly different colour

The skin around the area treated may become red or itchy. You should try to wear a hat when you go out in the sun as the skin is more sensitive.

Radiotherapy can make you feel sick, but there are quite a few different tablets you can take to control these symptoms.

Radiosurgery


This uses a highly focused beam of radiation which is directed at the tumour without affecting the normal surrounding tissue. The treatment is usually a single dose but sometimes more sessions are given for a large tumour or one that is located near to important structures, for example those responsible for vision. The majority of people do not experience any side effects but occasionally people report having a mild headache or dizziness for a short time. You won’t know immediately whether the treatment has worked as it takes 6-12 months for tumour to reduce in size. You will therefore be given regular MRI scans after the treatment to monitor the tumour. Radiosurgery isn’t suitable for meningiomas that are quite large (more than 3.5cm in diameter).

The treatment is also called gamma knife and is only offered at three centres in the UK:

Contents