Is Meningioma Surgery Dangerous?

• How is meningioma diagnosed?
• Treatment options for meningioma
• Surgical treatment of meningioma
• Is meningioma surgery dangerous?
• Seek a second opinion from a reliable source

Meningioma is a primary brain tumor that develops on the membranes that cover and protect the central nervous system called the meninges. Meningiomas are the most common among all types of brain tumors, accounting for more than 30% of all diagnosed tumor cases.

Most meningiomas are benign (non-cancerous). But even benign meningiomas can become problematic when they increase in size, as this can cause numerous problems when they press against different parts of the brain or spinal cord.

When a meningioma is diagnosed, doctors and surgeons can prescribe various forms of treatment to treat and manage these tumors. Among all these treatment options available, surgery is the most effective. However, just like any surgical procedure, it’s important to understand the risks associated with surgery and how these risks can potentially impact your life after surgery.

Is meningioma surgery dangerous? How dangerous is meningioma surgery? In the following sections, we delve into how meningioma is treated, the types of surgical treatments available and the risks associated with meningioma surgery to help you make an informed decision.

Meningioma is diagnosed after performing various tests to determine the presence of a brain tumor in specific brain areas. In some cases, meningioma is not explicitly tested and is detected accidentally during a procedure for a different reason such as headaches.

The type of tests conducted can vary, depending on several factors, including:

• Symptoms.
• Results of other medical tests including physical examination.

More commonly, meningioma is diagnosed after a patient starts exhibiting symptoms. The neuro-oncologist uses the clues these symptoms provide to estimate the tumor’s location and will order tests to detect the precise tumor location and size. The following tests may be used to diagnose a meningioma more accurately:

• Detailed neurological and sensory tests.
• Biopsy during stereotactic neurosurgery.
• Imaging tests, such as magnetic resonance imaging (MRI) and/or computed tomography (CT) scan.

Tests will confirm the presence, size, and location of a meningioma. The information they provide will help neuro-oncologists identify the best course of treatment from among the following:

• Observation: Patients with small tumors and few to no symptoms may be closely monitored before any other treatment is recommended. Meningiomas grow slowly, so their growth will be closely observed through periodic MRI scans. During this observation period, patients must report any change in their symptoms immediately.
• Medication: Different types of medication may be prescribed to provide relief and help patients manage their symptoms. These may include steroids to reduce swelling and edema around the tumor and anticonvulsants to prevent or control seizures.
• Surgery: Surgical methods of removal are often prescribed when meningioma is confirmed to be growing or when the patient’s symptoms are significant. Although complete removal is necessary to cure the patient completely, it is not always possible, especially when the tumor is attached to nerves or arteries. When this happens, the doctor may consider follow-up treatment with radiation.

Surgery is the most effective way to treat meningioma. It involves carefully removing the tumor from the brain physically, minimizing the damage to the surrounding tissues while ensuring its complete removal to lessen the chances of it growing back.

There are many ways to remove a meningioma surgically. The type of surgery will depend on the size and location of the tumor. The neurosurgeon will perform a series of tests to carefully assess the size and characteristics of the meningioma and determine its precise location to determine the best approach.

Here is an overview of some of the most common surgical procedures used to remove a meningioma:

• Craniotomy: A craniotomy is a procedure that involves opening the skull to gain access to a meningioma and other tumors found on the brain’s surface. In this procedure, the surgeon makes an incision in the scalp to remove a small part of the skull and create an opening. After removing the meningioma, the surgeon closes the hole using the removed portion of the skull and stitches the skin together.
• Endoscopic Endonasal Surgery: Meningiomas growing in the skull base may be accessible through the nose and are removed through endoscopic endonasal surgery. This is a minimally invasive procedure that doesn’t require opening the skull. Instead, a long, thin, lighted tube with a tiny camera on the end is placed through the nose and sinuses to view the skull base. Microinstruments are then used to remove as much of the meningioma as possible.
• Neuroendoscopic Surgery: Similar to a craniotomy, neuroendoscopic surgery requires creating a hole in the skull to access the meningioma. However, the hole created is much smaller and instead relies on an endoscope and microinstruments to remove the tumor. This surgical procedure is used for meningiomas found in the brain’s inner parts containing cerebrospinal fluid.
• Spinal Surgery: In spinal surgery, an incision is made in the upper or middle portion of the spine in the back. The surgeon then uses microinstruments to carefully cut open the meninges and remove the tumor. This entire procedure is done carefully to avoid damage to the spinal cord and nerves.

The main goal of meningioma surgery is to completely remove the meningioma to lessen the chances of it growing back. Unfortunately, in some cases, some parts may not be completely removed, especially when the growth appears in or near delicate structures of the brain or spinal cord.

Thus, further treatment after the initial surgery may be necessary. If the tumor is benign and small parts remain, the surgeon may recommend periodic follow-up scans to track the regrowth of the residual tumor.

The residual tumor may also be treated with a form of radiation treatment known as stereotactic radiosurgery. If the meningioma is found rarely to be malignant and a small portion remains after the surgery, you will most likely need radiation.

Surgery poses several risks to patients, including bleeding and infection. Other risks will depend on where the tumor is located. For example, meningioma surgery around the optic nerve may lead to partial vision loss. To learn more about the specific risks of surgery, ask your surgeon prior to the procedure.

Discussions on meningioma surgery risks may lead you to ponder, “Is meningioma surgery dangerous?” While there are risks to the surgical removal of meningioma, it is a relatively safe procedure, with a 5-year survival rate exceeding 80%, while 10- and 15-year survival rates exceed 70%.

Other risks of meningioma surgery include weakness, sensation changes, walking abnormalities and other neurological symptoms. Because meningioma tumors are usually outside the brain, their surgical removal is relatively safe.

The experience of the surgeon is very important to the outcome of the surgery, extent of tumor removal, and minimizing the overall risks of the surgery.

It’s important to understand all the risks of the procedure before making an important decision to undergo procedures such as meningioma surgery.

Take the time to research all the risks and benefits of the procedure thoroughly. More importantly, seek a second opinion from a trusted source of information that can help you weigh all available options.

Let experienced neurosurgeon Dr. Cohen-Gadol help you move forward in your meningioma treatment plan with confidence. Fill out this form to request a second opinion today.

• American Association of Neurological Surgeons 
• National Cancer Institute 
• American Brain Tumor Society 
• National Brain Tumor Society