Thus, meningiomas may be found on CT or MRI scans done to evaluate non-specific headaches or for other reasons such as head injury or sinusitis. The most definitive diagnosis for a meningioma is the plain and gadolinium enhanced MRI or the plain and iodine-enhanced CT scan. Often this is the only study needed to make the diagnosis. Some meningiomas may cause adjacent hypertrophy of the bone. Some may be very vascular and angiography is done for treatment planning or for presurgical embolic occlusion.
Most meningiomas are benign and surgically curable.
For tumors that are very vascular, the length of operation and the ease of surgical removal can be improved by occluding many of the feeding vessels through preoperative angiographic embolization of the vessels, specifically feeding the tumor. However, even when complete resection is felt to be obtained, recurrence can occur at a later time, even more than a decade. Extent of resection is correlated with the recurrence rate. Therefore, periodic follow-up CT or MRI scans are indicated. For benign meningiomas that are not able to be completely resected because of their intimate attachment to nerves, blood vessels or brain stem, postoperative fractionated radiation therapy has been shown to improve the length of progression-free survival.