The bedrock of meningioma treatment, in those cases where treatment is required, is surgery. It is emphasized that as described above, it may be that if your meningioma falls within the appropriate category, it may be possible to simply observe it over a period of time to see if it progresses. In terms of treatment, the options are radiotherapy and surgery. It would be fair to say that for the majority of intracranial and spinal meningiomas, the default position for treatment is surgical resection. This is aimed to physically remove the tumour, decompressing the adjacent brain and in the majority of cases providing cure.
In certain cases, radiotherapy may be an option. These would typically involve meningiomas in areas of the brain where surgical resection is either impossible or exposes the patient to excess risk. The second situation in which radiotherapy may be required is that in which the tumour is of an unusually aggressive nature. The vast majority of meningiomas are benign (World Health Organisation [WHO] Grade I) but occasionally the meningioma is WHO Grade II and even more rarely WHO Grade III (malignant meningioma). Should the meningioma not be Grade I, it may be advised that adjuvant radiotherapy should be given to minimise the chance of recurrence.
In terms of surgery, the surgical approach is designed to maximise the surgeon’s access to the tumour whilst minimising retraction of the adjacent brain. This approach is highly individualised to the tumour and would be discussed with you by the neurosurgeon you see at the Brain and Spine Clinic. The approach is designed to allow the surgeon to physically remove the tumour in as safe a fashion as possible and, therefore, with minimal risk of harm to the surrounding brain, nerves and blood vessels.