Overview
A meningioma is a tumor that arises from the meninges, the layers of tissue that cover the brain and spinal cord. Most meningiomas are benign and slow-growing. When they occur along the base of the skull, their effects and their treatment depend strongly on exactly where they are and which nearby structures they touch.
Skull base meningiomas can press on the optic nerves, other cranial nerves, blood vessels, or the brain, producing symptoms such as vision changes, headaches, or, depending on location, hormonal or other neurologic effects. Some are found incidentally on imaging done for another reason.
Management is individualized. Many small, asymptomatic meningiomas can be monitored, while others are treated with surgery, radiation, or a combination, chosen by a multidisciplinary team. When an endonasal approach is suitable, skull-base rhinology may be part of the team. This page is educational and does not replace specialist evaluation.
What a meningioma is
A meningioma arises from the meninges, the coverings of the brain. The majority are benign and grow slowly. They are common tumors overall, and when located along the skull base they require specialized evaluation because of the structures nearby.
Location-dependent symptoms
Symptoms depend on where the meningioma is. Tumors near the optic pathways can affect vision, those at the front of the skull base can affect the sense of smell, and others can cause double vision, facial numbness, headaches, or, in certain locations, hormonal effects. Many small meningiomas cause no symptoms and are found incidentally.
Living with skull base meningioma? The next step is a quiet, unhurried conversation.
MRI and observation
MRI is the main test used to identify a meningioma and define its location and relationship to nearby structures. Because many meningiomas are slow-growing and benign, small or asymptomatic tumors are often monitored with periodic imaging rather than treated immediately.
Endoscopic versus transcranial approaches
When treatment is needed, surgery may be performed endoscopically through the nose for certain midline skull-base locations, or through a transcranial (open) approach for others. Some tumors are best treated with a combination. The chosen route depends on the tumor's location and its relationship to nerves and vessels, with the aim of relieving pressure while protecting vital structures.
Radiation options
Radiation therapy, including focused techniques, is an option for some meningiomas, either as the main treatment in selected cases or after surgery when tumor remains. The plan is made with radiation oncology as part of multidisciplinary care.
Living with skull base meningioma? The next step is a quiet, unhurried conversation.
Vision, hormonal, and neurologic follow-up
Because skull base meningiomas and their treatment can affect vision, hormones, and other neurologic functions, long-term follow-up with appropriate testing and imaging is important to monitor for changes or recurrence.
When to seek care
Seek prompt evaluation for new or worsening vision changes, persistent headache, loss of smell, or facial numbness. Seek emergency care for sudden vision loss, severe headache, weakness, or confusion, which require immediate attention.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Living with skull base meningioma? The next step is a quiet, unhurried conversation.
Common Symptoms
Treatment Approach
Treatment for skull base meningioma is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Observation with periodic imaging for small, asymptomatic tumors
- 02Surgery by an endoscopic, open, or combined approach
- 03Radiation therapy in selected cases
- 04Coordinated, multidisciplinary planning
- 05Long-term vision, hormonal, and neurologic follow-up
Specialists who treat skull base meningioma
Dr. Adrian Ong
MD
Board-Certified Facial Plastic & Reconstructive and Head & Neck Surgeon
Dr. Adrian Ong is a board-certified surgeon who practices exclusively on the face, head, and neck, with expertise spanning rhinoplasty, sinus surgery, facial trauma, reconstruction, and sleep surgery.
- Functional and aesthetic rhinoplasty (including revision)
- Sinus surgery and complex revision sinus surgery
- Facial trauma and nasal fractures
- Head and neck cancer surgery and microvascular reconstruction
Also caring for this area
Not sure who to see? Our patient coordination team can help match you with the right specialist.
(212) 444-8006Frequently Asked Questions
Clinical References
These independent resources from medical and professional organizations offer further reading. They are provided for general education and do not replace a consultation with a clinician.
Related Procedures
1 of 1 · Endoscopic Skull Base Surgery
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