- The location of the brain tumor
- Whether the meningioma is benign or malignant
- The patient’s general health and preferences regarding potential treatment options
Surgery is the most common treatment for a meningioma. If a meningioma is benign and in a part of the brain where neurosurgeons can safely completely remove it, surgery is likely to be the only treatment needed. For some, total resection surgery is all that is needed for treatment, followed by periodic imaging to monitor any recurrence of a tumor.
Doctors may use radiation therapy after surgery for the most malignant meningiomas or when the neurosurgeon cannot completely remove the meningioma. Radiation therapy is also used to treat meningiomas in locations where surgery is not safe.
For a small meningioma that does not cause any significant signs or symptoms, monitoring the tumor without any immediate treatment, called observation, may be an option. If the meningioma does not grow further, the patient may never need treatment.
Observation means seeing a neurosurgeon and having imaging tests done periodically. There are cases in which the meningioma is found incidentally and is causing no symptoms, and the neurosurgeon may recommend watchful monitoring or observation. Treatment may be necessary later, for example, if the tumor grows or symptoms develop or worsen.
The most common type of surgery to remove a meningioma is called a craniotomy. This procedure involves making an incision in the scalp and removing a piece of bone from the skull. The neurosurgeon can then access and remove the tumor, or as much of the tumor as possible without risk of severe damage to the brain. The neurosurgeon then replaces the bone and closes the incision. Learn more about surgery for other types of brain tumors.
After surgery, a team of doctors and nurses who are who are specially trained in neurology and critical care will help the patient recover. Before the patient leaves The Johns Hopkins Hospital, they will provide detailed instructions about what to do at home.
Post-surgery, all patients receive a comprehensive assessment for neurological and cognitive needs. Learn more about care and recovery after surgery.
Radiation therapy is the treatment of tumors using X-rays and other forms of radiation (light energy) to destroy cancer cells or prevent the tumor from growing. It is also called radiotherapy. Radiation therapy may be used to treat meningiomas that are malignant by location, which means that although the tumor itself may not be pathologically cancerous, the tumor's location is dangerous. For example, a meningioma may form around the carotid artery. Skull base meningiomas can also be difficult to operate on due to their location. In these cases, radiation therapy might be used post-surgery to radiate residual tumor in precise areas of the brain.
Two types of radiation therapy are used to treat meningioma:
After surgery, a patient may require assistance in recovering. Rehabilitation specialists at Johns Hopkins will provide assistance with physical therapy, occupational therapy, and speech language pathology. Learn more about the rehabilitation services offered at Johns Hopkins Meningioma Center.