How Meningioma Is Diagnosed

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Meningioma is the most common type of primary brain tumor (one that starts in the brain and doesn't spread from elsewhere in the body). The origin of the tumor is in the meninges, which are the membranes that surround and protect the spinal cord and brain.

To diagnose meningioma, healthcare providers perform a physical and neurological exam. In addition, they will likely perform specific imaging tests to view the brain, and if there is evidence of a tumor, they will likely perform a biopsy to determine if it is malignant (cancerous). 

This article explains what tests and procedures healthcare providers use to diagnose meningioma.

Doctor helps a person prepare for an MRI scan

Dennis Degnan / Getty Images

Meningioma makes up 30% of all brain tumors. Most of the time, they are benign (noncancerous).

Self-Checks

There is no way to self-screen for brain tumors, including meningioma. Often symptoms are subtle or nonexistent, especially when the tumor is small. 

However, it can help to know what symptoms to watch out for. If you notice any of the following, see your healthcare provider for further evaluation:

  • Changes in vision
  • Loss of hearing or smelling
  • Confusion
  • Headaches (especially morning headaches)
  • Seizures

Physical Exam

During a physical exam, your healthcare provider will take a detailed medical history, gathering information about your symptoms. Be prepared to tell them when symptoms began and if you notice any triggers that bring them on.

Your healthcare provider will also likely perform a neurological exam, looking for signs of problems with your brain and nervous system. Neurological exams test the following:

  • Mental state: Your provider will ask you questions to test your awareness of your surroundings, and they will look for your ability to demonstrate awareness of person, place, and time.
  • Motor function: During this test, your healthcare provider may ask you to push or pull on their hands or to stand or walk so they can observe your balance and coordination.
  • Sensory: Your healthcare provider may use tuning forks, rubbing alcohol, and needle pricks to test the function of your senses.
  • Reflexes: This test involves your healthcare provider tapping your knee and elbow with a reflex hammer.
  • Brain nerves: To evaluate the 12 primary nerves in your brain, you may be asked to identify smells, do a hearing and vision test, perform a variety of facial movements, and your gag reflex with a tongue depressor.

Your healthcare provider may refer you to a neurologist, a medical doctor who specializes in the brain and nervous system.

Imaging

Imaging is a central component in the diagnosis process because it allows a medical professional to view your brain. That way, if a tumor is present, they can measure its size and shape.

If a physical and neurological exam indicates the possibility of meningioma, your healthcare provider will likely order one or more types of imaging tests. 

Magnetic Resonance Imaging (MRI)

An MRI uses a magnetic field and radio waves to capture images of your body—in this case, the brain. The scan takes place in a hospital or an outpatient radiology center. 

The scan itself typically takes between 45 minutes to more than an hour. However, you should plan to be there longer, especially if you will receive contrast or sedation.

Claustrophobia

People who are claustrophobic may have trouble with an MRI, so if you have even mild claustrophobia, talk to your healthcare provider. They may be able to offer you a mild sedative. 

During the scan, you will be inside a giant magnet. To obtain a clear image, you must lie perfectly still.

MRIs are not painful, but the machine often makes very loud sounds. So, the technician will offer you ear protection for your comfort and safety. In addition, you will be able to talk to and hear the technician through a speaker in the MRI machine the entire time.

Contraindications

While an MRI is an excellent tool for viewing the body's structures, it isn't suitable for everyone. For instance, the following people should not have an MRI:

  • Those with metal in their body
  • Those with implanted electronic or medical devices
  • Pregnant people
  • People with tattoos (some dark inks contain metal)

Computed Tomography (CT Scan)

A CT scan uses X-ray images to form a three-dimensional image, which allows your healthcare provider to look at your brain from different angles.

While an MRI is better at capturing images of soft tissues, like the brain, MRIs are far more expensive, and certain people cannot undergo the procedure. In some situations, a CT scan may be the better choice.

Contrast

Contrast agents are often used in CT scans. These dyes can help a healthcare provider see a specific part of your body more clearly. They will let you know if your CT scan requires a contrast. 

During the test, you will lie on a table, which the technician will move into the circular machine. Unlike the MRI, the CT machine only goes over the part of your body that is scanned. Otherwise, your body is outside of the device.

In addition, unlike an MRI, the CT scan is silent. It is essential to lie perfectly still to get a clear picture. When the test is over, the bed will slide out of the machine.

Biopsy

A biopsy is a procedure in which a tumor sample is removed and then analyzed in a lab. Neurosurgeons typically perform brain tumor biopsies. Biopsies are the most accurate way to diagnose meningiomas.

To undergo a brain biopsy, you will require surgery. During surgery, your healthcare provider will make a hole the size of a quarter in the scalp, open the brain's covering, and then carefully extract cells from the tumor with a needle.

A brain biopsy is an inpatient procedure. That means you will need to stay overnight in the hospital. However, your incision site will remain bandaged for several days, and you can get your sutures out in about two weeks. Lab results may take three to four days.

Differential Diagnosis 

Many brain tumors can mimic meningiomas. These include:

Summary

Doctors diagnose meningiomas through a physical and neurological exam, imaging tests, and biopsy. Since it can be challenging to differentiate between the different kinds of brain tumors, a biopsy is the surest way to know whether your tumor is a meningioma or something else. It can also tell you whether or not it is cancerous.

A Word From Verywell

There is no way to screen for meningiomas at home. However, being aware of the symptoms can alert you to the need to see a healthcare provider. If you notice disturbances in any of your senses, confusion, headaches, or seizures, you should see a medical professional for an evaluation.

While the thought of a brain tumor can be frightening, remember that meningiomas are the most common form of primary brain tumor. The good news is that most of the time, they are not cancerous.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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