10 Warning Signs and Symptoms of Meningioma You Should Know

A meningioma is a tumor that develops from the meninges, the protective membranes surrounding the brain and spinal cord. While most meningiomas are benign (non-cancerous), they can still cause significant health problems as they grow and press against the brain or spinal cord. Meningiomas account for approximately 30% of all brain tumors, making them the most common primary brain tumor in adults.

The symptoms of meningioma can vary greatly depending on the tumor’s size, location, and growth rate. Some people may have a meningioma for years without experiencing any symptoms, while others may develop noticeable signs relatively quickly. Understanding these symptoms is crucial for early detection and timely medical intervention.

In this comprehensive guide, we’ll explore the ten most common symptoms of meningioma, helping you recognize the warning signs that warrant medical attention.

1. Persistent Headaches

Headaches are one of the most common symptoms of meningioma, affecting a significant number of patients. These headaches typically differ from regular tension headaches or migraines in several important ways.

Meningioma-related headaches often:

• Occur more frequently in the morning or worsen upon waking
• Gradually increase in intensity over weeks or months
• May be accompanied by nausea or vomiting
• Don’t respond well to typical over-the-counter pain medications
• Worsen with activities that increase intracranial pressure, such as coughing, sneezing, or bending over

The headaches result from increased pressure inside the skull as the tumor grows, or from the tumor irritating pain-sensitive structures in the brain. The location of the headache may correspond to the tumor’s position, though this isn’t always the case. If you experience persistent or progressively worsening headaches that differ from your usual pattern, it’s important to consult a healthcare provider.

2. Vision Problems

Vision disturbances are particularly common when meningiomas develop near the optic nerve or in areas that affect visual processing. These vision problems can manifest in various ways and may affect one or both eyes.

Common visual symptoms include:

• Blurred or double vision (diplopia)
• Loss of peripheral vision
• Decreased visual acuity
• Seeing flashing lights or spots
• Partial vision loss in one or both eyes
• Difficulty reading or focusing on objects

Meningiomas located along the optic nerve sheath can directly compress the nerve, leading to progressive vision loss. Tumors in other locations may affect vision by increasing intracranial pressure or interfering with the brain regions responsible for processing visual information. Vision changes associated with meningioma typically develop gradually, though in some cases they can appear suddenly. Any unexplained changes in vision should be evaluated promptly by an eye specialist or neurologist.

3. Seizures

Seizures occur in approximately 20-40% of patients with meningioma, making them one of the most significant symptoms. For many patients, a seizure may be the first indication that something is wrong, particularly if they have no previous history of epilepsy.

Meningioma-related seizures can present as:

• Focal (partial) seizures affecting one part of the body
• Generalized seizures involving loss of consciousness and full-body convulsions
• Absence seizures characterized by brief periods of staring or unresponsiveness
• Simple focal seizures with unusual sensations, tastes, or smells
• Complex focal seizures causing confusion or automatic behaviors

Seizures occur when the tumor irritates the surrounding brain tissue, disrupting normal electrical activity. The type of seizure often depends on the tumor’s location. Convexity meningiomas (those on the brain’s outer surface) are more likely to cause seizures than those at the skull base. If you experience a seizure for the first time, especially as an adult, immediate medical evaluation is essential to determine the underlying cause.

4. Memory Loss and Cognitive Changes

Cognitive symptoms can develop when meningiomas affect areas of the brain responsible for memory, thinking, and information processing. These changes may be subtle at first and gradually worsen as the tumor grows.

Cognitive symptoms may include:

• Short-term memory problems
• Difficulty concentrating or maintaining attention
• Confusion or disorientation
• Problems with problem-solving or decision-making
• Slowed thinking or processing speed
• Difficulty finding the right words during conversation
• Changes in judgment or reasoning abilities

These symptoms are particularly common when meningiomas develop in the frontal or temporal lobes of the brain. Family members or colleagues may notice these changes before the patient does, as cognitive decline can be gradual. Memory and cognitive changes can significantly impact daily activities, work performance, and quality of life. It’s important to note that while these symptoms can be concerning, they don’t necessarily indicate a brain tumor—many conditions can cause similar symptoms. However, progressive cognitive decline warrants thorough medical evaluation.

5. Weakness or Numbness in Limbs

Weakness or numbness in the arms, legs, or one side of the body can occur when a meningioma presses on areas of the brain that control motor function or sensation. These symptoms may develop gradually or appear suddenly, depending on the tumor’s growth rate.

Motor and sensory symptoms may present as:

• Progressive weakness in an arm or leg
• Numbness or tingling sensations
• Difficulty with fine motor tasks like buttoning shirts or writing
• Unsteadiness or lack of coordination
• Dragging one foot while walking
• Reduced grip strength
• Altered sensation to temperature or touch

Parasagittal meningiomas, which grow along the midline of the brain, commonly cause leg weakness or numbness. The symptoms typically affect the opposite side of the body from where the tumor is located due to the way the brain’s motor pathways cross over. These symptoms can initially be mistaken for stroke, especially if they appear suddenly. However, unlike stroke symptoms, meningioma-related weakness usually develops more gradually and may fluctuate. Any unexplained weakness or numbness, particularly if progressive or affecting one side of the body, requires immediate medical attention to rule out serious conditions.

6. Hearing Loss or Tinnitus

Hearing problems can develop when meningiomas grow in or near the internal auditory canal or the cerebellopontine angle—the area between the cerebellum and pons where the hearing nerve is located. These acoustic symptoms may affect one or both ears, though unilateral (one-sided) hearing loss is most common.

Auditory symptoms include:

• Gradual hearing loss in one ear
• Ringing in the ears (tinnitus)
• Difficulty hearing high-pitched sounds
• Problems understanding speech, especially in noisy environments
• Feeling of fullness or pressure in the ear
• Dizziness or balance problems accompanying hearing loss

Meningiomas in the cerebellopontine angle can compress the vestibulocochlear nerve (eighth cranial nerve), which carries both hearing and balance information from the inner ear to the brain. The hearing loss typically develops gradually over months or years, which can lead people to attribute it to aging or noise exposure. However, asymmetric hearing loss—where one ear is significantly worse than the other—is a red flag that warrants investigation. If you notice progressive hearing loss, especially if accompanied by tinnitus or balance problems, an audiological evaluation and imaging studies may be necessary.

7. Balance and Coordination Problems

Difficulties with balance and coordination can occur when meningiomas affect the cerebellum, brainstem, or other areas involved in movement control. These symptoms can significantly impact daily activities and increase the risk of falls.

Balance and coordination issues may manifest as:

• Unsteady gait or walking difficulties
• Frequent stumbling or falling
• Dizziness or vertigo
• Difficulty with precise movements
• Feeling as though the room is spinning
• Problems with hand-eye coordination
• Difficulty maintaining posture
• Nausea associated with movement

Posterior fossa meningiomas, which develop in the lower back portion of the skull where the cerebellum is located, are particularly likely to cause balance problems. The cerebellum plays a crucial role in coordinating voluntary movements and maintaining equilibrium. When compressed by a tumor, its function becomes impaired, leading to ataxia (lack of coordination). Balance problems can also result from increased intracranial pressure affecting the vestibular system, which controls balance and spatial orientation. These symptoms can be particularly dangerous in older adults, as they increase fall risk and potential for injury. If you’re experiencing unexplained balance problems, especially if progressive or accompanied by other neurological symptoms, seek medical evaluation.

8. Personality and Behavioral Changes

Changes in personality and behavior can be among the most distressing symptoms of meningioma, both for patients and their loved ones. These changes are most common when tumors affect the frontal lobe, which plays a key role in personality, emotional regulation, and social behavior.

Behavioral and personality changes may include:

• Increased irritability or mood swings
• Apathy or loss of interest in previously enjoyed activities
• Inappropriate social behavior or loss of social inhibitions
• Depression or anxiety
• Changes in emotional responses (laughing or crying inappropriately)
• Reduced motivation or initiative
• Impulsivity or poor judgment
• Aggression or hostility that is out of character

These changes often develop gradually, making them easy to overlook or attribute to stress, aging, or psychiatric conditions. Family members may notice that their loved one seems “different” or “not themselves,” but may struggle to identify specific changes. Frontal lobe meningiomas can impair executive functions—the mental skills that include flexible thinking, self-control, and working memory—leading to noticeable changes in how a person thinks and behaves. It’s important to recognize that personality changes can be neurological symptoms rather than simply psychological issues, especially when they appear in someone with no prior psychiatric history or when they occur alongside other neurological symptoms.

9. Speech Difficulties

Speech and language problems can develop when meningiomas affect areas of the brain responsible for language production and comprehension. These symptoms can range from mild word-finding difficulties to more severe communication impairments.

Speech-related symptoms may include:

• Difficulty finding the right words (anomia)
• Slurred or unclear speech (dysarthria)
• Problems with speech fluency
• Difficulty understanding spoken or written language
• Speaking in short, incomplete sentences
• Using incorrect words or nonsensical phrases
• Trouble with reading or writing
• Reduced speech volume or monotone voice

The specific type of speech difficulty depends on the tumor’s location. Meningiomas affecting Broca’s area (typically in the left frontal lobe) may cause expressive aphasia, where patients have difficulty producing speech but can understand language relatively well. Tumors affecting Wernicke’s area (typically in the left temporal lobe) may cause receptive aphasia, where speech production is fluent but doesn’t make sense, and comprehension is impaired. Speech difficulties can be particularly frustrating and isolating for patients, as they may know what they want to say but cannot express it effectively. These symptoms can also be mistaken for confusion or cognitive decline. Any new or progressive speech difficulties should be evaluated by a neurologist, as they may indicate a serious underlying condition.

10. Nausea and Vomiting

Nausea and vomiting can occur as symptoms of increased intracranial pressure caused by a growing meningioma. These symptoms have distinct characteristics that differentiate them from gastrointestinal causes.

Characteristics of tumor-related nausea and vomiting include:

• Morning vomiting, often upon waking
• Vomiting without preceding nausea (projectile vomiting)
• Persistent nausea not relieved by typical remedies
• Vomiting that occurs with headaches
• Symptoms worsening with position changes
• No apparent connection to food intake
• Accompanied by other neurological symptoms

These symptoms occur because increased pressure within the skull affects the brain’s vomiting center in the medulla oblongata. The pressure can be caused by the tumor itself, swelling of surrounding brain tissue (edema), or obstruction of cerebrospinal fluid pathways leading to hydrocephalus. Morning vomiting is particularly characteristic because lying flat during sleep can increase intracranial pressure. When nausea and vomiting occur alongside persistent headaches, vision changes, or other neurological symptoms, they should not be dismissed as a simple stomach bug. While many common conditions cause nausea and vomiting, the pattern and associated symptoms can help distinguish a serious neurological cause that requires immediate evaluation.

What Causes Meningioma?

The exact cause of meningioma remains unclear in most cases, but researchers have identified several risk factors and potential contributing elements:

Radiation Exposure

Previous radiation therapy to the head, particularly during childhood, significantly increases the risk of developing meningioma. This includes radiation treatment for other cancers, such as leukemia or brain tumors. Dental X-rays and other low-dose radiation exposures have not been definitively linked to increased risk.

Genetic Factors

Certain genetic conditions increase meningioma risk, most notably Neurofibromatosis type 2 (NF2), a hereditary disorder that causes benign tumors to grow on nerves. People with NF2 have approximately a 50% chance of developing meningiomas. Researchers have also identified mutations in specific genes that may contribute to meningioma development.

Hormonal Influences

Meningiomas are more common in women than men, particularly after menopause, suggesting a hormonal component. Many meningiomas have receptors for progesterone and, less commonly, estrogen. Some meningiomas may grow faster during pregnancy or in association with breast cancer, further supporting hormonal involvement. However, the relationship between hormones and meningioma growth is complex and not fully understood.

Age

Meningiomas become more common with advancing age, with the majority diagnosed in people between 40 and 70 years old. They are rare in children, accounting for only 1-4% of childhood brain tumors.

Head Injury

Some studies have suggested a possible link between head trauma and meningioma, though this connection remains controversial and not definitively proven.

Obesity

Emerging research suggests that obesity may be associated with an increased risk of developing meningioma, though more studies are needed to confirm this relationship.

It’s important to note that having one or more risk factors doesn’t mean a person will develop meningioma. Many people with meningiomas have no identifiable risk factors, and the tumors develop spontaneously.

Prevention

Unfortunately, there is no proven way to prevent meningioma, as the exact causes remain largely unknown. However, you can take certain steps to potentially reduce your risk or ensure early detection:

Minimize Unnecessary Radiation Exposure

While necessary medical radiation shouldn’t be avoided, discuss with your healthcare provider whether imaging studies involving radiation are truly needed. Ensure that protective shielding is used appropriately during X-rays and other radiological procedures.

Genetic Counseling

If you have a family history of Neurofibromatosis type 2 or other genetic conditions associated with brain tumors, consider genetic counseling and testing. Early identification of genetic risk factors can lead to more vigilant monitoring.

Regular Medical Check-ups

Maintain regular health screenings and promptly report any unusual or persistent neurological symptoms to your healthcare provider. Early detection of meningiomas, even when asymptomatic, may allow for better monitoring and treatment outcomes.

Maintain Overall Health

While not specifically proven to prevent meningioma, maintaining a healthy lifestyle—including regular exercise, a balanced diet, maintaining a healthy weight, and avoiding smoking—supports overall brain health and may reduce cancer risk in general.

Stay Informed

Keep up to date with your family medical history and inform your doctors about any relatives who have had brain tumors. Be aware of the symptoms of meningioma so you can recognize potential warning signs early.

Remember that most people will never develop a meningioma, and many meningiomas that do develop are slow-growing and may never cause symptoms. The focus should be on awareness and early detection rather than excessive worry about prevention.

Frequently Asked Questions

How fast do meningiomas grow?

Most meningiomas are slow-growing tumors, typically increasing in size by only 1-2 millimeters per year. However, growth rates vary significantly depending on the tumor grade. Grade I (benign) meningiomas grow very slowly and may remain stable for years. Grade II (atypical) meningiomas grow somewhat faster, while Grade III (malignant) meningiomas can grow rapidly. Some meningiomas may not grow at all over many years of observation.

Can meningiomas be cancerous?

The vast majority of meningiomas (approximately 80-85%) are benign (Grade I). About 15-20% are classified as atypical (Grade II), showing more aggressive features and higher recurrence rates. Only 1-3% are malignant or anaplastic (Grade III), which are cancerous, grow rapidly, and are more likely to invade surrounding tissues. Even benign meningiomas can cause serious symptoms depending on their location and size.

Can you have a meningioma without symptoms?

Yes, many meningiomas are asymptomatic, especially small ones. These tumors are often discovered incidentally during brain imaging performed for other reasons, such as after head injury or during evaluation of unrelated symptoms. Studies suggest that up to 1-2% of the general population may have small, asymptomatic meningiomas. Whether an asymptomatic meningioma requires treatment depends on its size, location, and growth rate.

Are meningiomas hereditary?

Most meningiomas are not hereditary and occur sporadically without any family history. However, in rare cases, meningiomas can be associated with inherited genetic conditions, particularly Neurofibromatosis type 2 (NF2). People with NF2 have a significantly increased risk of developing multiple meningiomas. If multiple family members have had meningiomas or other tumors, genetic counseling may be recommended to assess whether an inherited syndrome is present.

What is the difference between meningioma and glioma?

Meningiomas and gliomas are different types of brain tumors arising from different cells. Meningiomas develop from the meninges (the membranes covering the brain and spinal cord) and are usually benign. Gliomas arise from glial cells within the brain tissue itself and tend to be more aggressive. Meningiomas typically grow on the brain’s surface and push against it, while gliomas infiltrate into brain tissue. Treatment approaches and prognosis differ significantly between these tumor types.

Do meningiomas always require surgery?

Not all meningiomas require immediate surgical intervention. Small, asymptomatic meningiomas may be monitored with regular imaging studies, especially in elderly patients or those with significant medical conditions that make surgery risky. Treatment decisions depend on multiple factors including tumor size, location, growth rate, symptoms, patient age, and overall health. Your healthcare team will develop an individualized plan that may include observation, surgery, radiation therapy, or a combination of approaches.

Can stress cause meningioma?

There is no scientific evidence that stress causes meningioma. While chronic stress can affect overall health and immune function, it has not been identified as a risk factor for developing brain tumors. However, the symptoms of meningioma may be exacerbated by stress, and living with an undiagnosed condition can certainly cause significant stress and anxiety.

How is meningioma diagnosed?

Meningioma diagnosis typically involves several steps. After a neurological examination to assess symptoms and function, imaging studies are performed. MRI (magnetic resonance imaging) is the preferred method for visualizing meningiomas, providing detailed images of the tumor’s size, location, and relationship to surrounding structures. CT (computed tomography) scans may also be used. In most cases, the characteristic appearance on imaging is sufficient for diagnosis. A definitive diagnosis requires pathological examination of tumor tissue, which is usually obtained during surgical removal or through biopsy.

References:

• Mayo Clinic – Meningioma
• Johns Hopkins Medicine – Meningiomas
• National Cancer Institute – Meningioma
• American Association of Neurological Surgeons – Meningiomas
• National Institute of Neurological Disorders and Stroke – Meningiomas