Meningiomas are one of the most common types of tumors that affect the membranes surrounding the brain, and they are often non-malignant tumors, but they may cause annoying and dangerous symptoms due to pressure on sensitive brain tissues, so in many cases, resorting to meningioma surgery is the best solution to treat the issue and restore the patient’s health. In this article, we will review when a patient needs to undergo this surgery, how it is performed, and what the expected success rates are, so that you can be fully aware of everything related to this vital treatment in a simple and reassuring scientific manner.
What are meningiomas?
Meningioma is the most common type of tumor in the head (accounting for 39% of all primary brain tumors). It is a tumor that grows from the membranes surrounding the brain and spinal cord, called meninges, which means that a meningioma is not a brain tumor, but it may compress the brain, nerves, and nearby blood vessels, requiring urgent surgical intervention. Meningiomas can arise after previous treatment with ionizing radiation or overexposure to X-rays. They are common in both men and women, more common in women, and are often discovered at an advanced age, but can occur at any age.
Most meningiomas are non-malignant or low-grade tumors; most grow very slowly and can grow over many years without causing symptoms; however, their effects can cause serious impairment to nearby brain tissue, nerves, or blood vessels. In some cases, the growth of meningiomas can extend to the bones of the head and face, which can cause visible changes, and in very rare cases may invade the skull or spread to the skin or lungs.
There is no way to predict the growth rate of a meningioma or know for sure how long a tumor will grow before diagnosis. Meningiomas are graded from low to high, and the lower the grade, the lower the risk of recurrence and aggressive growth. The World Health Organization (WHO) classification divides meningiomas into three grades:
- Grade 1: Benign meningioma
- Grade 2: Atypical meningioma
- Grade 3: Malignant (anaplastic) meningioma
Symptoms of meningiomas
Symptoms of meningioma often start slowly and may be difficult to notice at first, and sometimes they do not cause any symptoms, and the tumor is discovered by chance, as the symptoms depend on the location of the meningioma in the brain or rarely in the spine, where the symptoms include the following:
- nausea and vomiting
- amnesia
- Epileptic seizures
- Loss of sense of smell
- Difficulty speaking
- A headache that gets worse in the morning
- Hearing loss or tinnitus
- Behavioral and cognitive changes
- Weakness in the arms or legs
- Vision changes, such as double vision or blurry vision
Meningioma treatment
Treatment of a meningioma depends on the size and location of the tumor, and meningiomas are often discovered incidentally in brain scans ordered for other reasons (such as head injuries). For small, asymptomatic meningiomas, active surveillance is sometimes the best option. Scans (such as MRI, CT, and DOTATATE PET) are performed at regular intervals to assess tumor growth, and any new or unusual symptoms should be reported to the doctor immediately.
Since the vast majority of meningiomas are benign (non-cancerous), the most common treatment is meningioma surgery, where the goal is to remove the meningioma completely, as this reduces the chances of recurrence. Sometimes, radiation can help reduce the size of the meningioma before meningioma surgery is performed. Radiation therapy or stereotactic radiosurgery (SRS) can also be used to treat tumors that cannot be safely removed surgically, or a residual tumor that could not be completely removed during surgical oncology surgery, and this procedure can also be used when the patient is too sick to undergo surgery.
As for malignant (cancerous) tumors and recurrent tumors, radiation therapy or stereotactic radiosurgery (SRS) can be used for treatment, and drug therapy can be used to treat meningiomas that cannot be removed by meningioma surgery, when radiation therapy is contraindicated, or in case of meningioma recurrence or return, where drug therapy can include targeted treatment of the meningioma mutation either by pills, infusion or injection.
When does a patient need meningioma surgery?
Although most symptoms of a meningioma appear slowly, in some cases, a meningioma may require immediate care and meningioma surgery to manage the condition and prevent it from worsening. The neurosurgeon takes several factors into consideration before recommending meningioma surgery, including:
- Size: Meningiomas of all sizes are treated with meningioma surgery. Some small tumors require surgery if they compress important nerves or vessels; however, the larger the meningioma, the more likely it is to require surgery.
- Symptoms: Some tumors cause symptoms because they press on areas of the brain. These symptoms include headaches that are worse in the morning, nausea, vomiting, sudden seizures, or weakness, and movement issues.
- Location: If the tumor causes sudden changes in vision or memory, or pressure on nerves or blood vessels, meningioma surgery may be required.
- Growth: If the tumor is growing rapidly, it may require meningioma surgery.
Do not hesitate to seek emergency care and schedule an appointment with your doctor if you are experiencing persistent symptoms that concern you, so that you can undergo a surgical evaluation and the appropriate treatment decision can be made.
How is meningioma surgery performed, and what are the chances of recovery?
The surgeon customizes the appropriate procedure based on the location of the tumor, often using 3D images to help him determine the best surgical options for the case, and the surgical technique depends on the size and location of the tumor, as the doctor seeks to remove the entire tumor while preserving the integrity of the surrounding tissues and nerves.
Meningioma surgery is performed using advanced medical techniques such as surgical microscopy and endoscopy that allow the surgeon to see the tumor clearly and accurately during the operation with any object during the procedure. Four types of meningioma surgery are used to treat meningiomas:
Traditional surgery (open meningioma surgery)
Craniotomy is a surgical procedure that occurs under general anesthesia where a temporary opening is made in the skull to remove a meningioma on the surface of the brain or in some areas of the base of the skull through it, then the opening is repaired at the end of the surgery and the surgeon puts the bone back in place and fixes it with titanium plates and screws, the incision is usually in the scalp behind the hairline and is not visible after recovery, and a surgical microscope is used during it to remove as much of the tumor as possible. It may be the procedure of choice for large or complex tumors.
Neuroendoscopic surgery
In some cases, the surgeon may be able to access the meningioma using precise techniques through small incisions in the skull, where an endoscope and surgical instruments are used under the guidance of computer images to reach the tumors in the chambers of the ventricles. This procedure is less painful and faster to recover from, but it is suitable for small tumors and appropriate locations.
Endoscopic endonasal surgery
Nasal endoscopic surgery is performed to remove a meningioma at the base of the skull that can be accessed through the nose. This procedure also requires general anesthesia and is less invasive, as the skull is not opened, but surgeons use a thin tube with a camera to see and remove the tumor.
Spinal surgery
Spine surgery is performed to remove a meningioma in the spine, where the surgeon makes an incision in the back and uses precise instruments to remove the tumor while avoiding the spinal cord and important nerves, as this procedure requires general anesthesia.
What are the chances of recovery after meningioma surgery?
Although there are risks in meningioma surgery, it is a relatively safe procedure thanks to these precise techniques, as the chances of recovery after meningioma surgery are high, especially when the tumor is completely resectable without affecting vital nerve centers, as the 5-year survival rate exceeds 80%, while the 10 and 15-year survival rate exceeds 70%, and careful medical follow-up after meningioma surgery is necessary to ensure rapid recovery and reduce the risk of complications, thus enhancing the patient’s quality of life after surgery and increasing survival rates.
The 5-year relative survival rates for benign (noncancerous) meningiomas by age group are as follows:
- Children (0-14): 96.5%
- Teens and young adults (15-39): 97.2%
- Adults (40+): 87.6%
The 5-year relative survival rates for malignant (cancerous) meningiomas by age group are as follows:
- Children (0-14): 79.6%
- Teenagers and young adults (15-39): 84.4% Adults (40+): 65.1%
Ultimately, meningioma surgery is an effective and safe option when the condition requires urgent medical intervention to relieve the tumor’s pressure on sensitive brain tissue. By relying on the latest medical techniques, the chances of successfully removing the tumor while minimizing the risks are increased, allowing patients to recover and improve their quality of life.
Don’t let fear stop you from consulting a doctor—early treatment through meningioma surgery can make a significant difference in both quality of life and full recovery.
Sources:
- Johns Hopkins Medicine. (2025, May 29). Meningioma treatment.
- American Brain Tumor Association. (n.d.). Meningioma
