Diagnosis

Initial diagnosis of a meningioma may be challenging. Because these tumors arise from the meninges, the delicate membrane that covers the entire brain and spinal cord, meningiomas can present with numerous symptoms. In many cases, meningiomas appear to grow slowly, which allows the adjacent brain tissue to gradually adapt to compression. With the increased availability of MRI scans and other diagnostic imagery techniques, a greater number of meningiomas are now diagnosed as incidental findings.

If meningiomas remain asymptomatic and do not present an immediate threat to life or health, they may be monitored with annual (or more frequent) follow-up scans. In contrast, other meningiomas are diagnosed from imaging studies performed to identify the source of seizures, headaches, visual changes or other manifestations.

Meningiomas can produce symptoms in different ways, including compression of the brain or cranial nerves, vascular injuries or irritation of the cortex that can lead to seizure activity. In some cases, the location of the tumor may be associated with specific neurological symptoms. However, similar symptoms may result from other conditions and are not necessarily associated with any brain tumors. Effective neuroimaging is an essential part of any differential diagnosis for meningiomas and other intracranial tumors. In most cases, MRI scans with contrast provide the diagnostic information needed. When MRI scans are contraindicated or when hyperostosis occurs, CT scans may also be useful.  

Among the frequent symptoms that may be caused by these primary brain tumors are seizures, headaches, muscle weakness, confusion, changes in personality, and visual disorders. Because other diseases can cause similar symptoms, misdiagnosis is common prior to identification of the tumor through diagnostic imaging. Unfortunately, particularly among mid-life women (who are statistically most likely to develop these tumors), vague symptoms may be ascribed to menopause or to illnesses such as endocrine disorders, depression, or autoimmune disorders. 

Reprinted from Meningioma: A Guide for Nurses and Other Healthcare Professionals (PDF)