Meningioma, Schwannoma & Neurofibromatosis Treatment

Meningiomas arise from the layers of membrane that cover the brain and spinal cord, not from the brain tissue itself.

Some 90 percent of meningiomas are benign — that is, they are not likely to spread throughout the body and tend to grow slowly over months or even years.

However, meningiomas can become quite large and crowd the brain and other structures inside the skull.

Brain tumor treatment depends on the size and location of the tumor. Sometimes, what doctors’ call watchful waiting or observation, is sufficient for small meningiomas that aren’t growing too close to critical nerves or blood vessels or irritating the brain.

Your doctor may have you come in for a brain scan every three to six months for the first year.

Since most meningiomas are benign (noncancerous), they are most commonly treated with surgery. Total meningioma removal is preferred since it lessens the chances of the tumor returning.

Sometimes radiation can help reduce the size of a meningioma. Radiation may also be considered to treat small remains of the tumor after surgery. This procedure can also be used when a patient is too ill to undergo surgery. The patient is provided various treatment options by Dr. Abdul Baker, just like robotic spine surgery and minimally invasive treatment options.

Along with meningioma, Dr. Baker also treats Schwannoma and Neurofibromatosis with advanced surgical techniques and radiation therapy.

Your neurosurgeon will carefully assess the size, characteristics, and, most importantly, the location of the meningioma.

The best procedure for your situation may involve a craniotomy, which is surgically making a temporary window in the skull and removing the tumor through that opening. The opening is repaired at the end of the surgery. The incision is usually behind the hairline and is not obvious once it heals.

In some situations, your surgeon may be able to reach the meningioma using an instrument called an endoscope, accessing the tumor through the nose.

Surgery is more simple if the tumor is located close to the brain’s surface near the skull (a convexity meningioma). The surgeon may need to move the brain tissue aside for meningiomas located deeper in the brain. Meningiomas can grow in a number of places, including:

Blood vessels: Meningiomas growing into blood vessels present problems. The sagittal sinus is a large vein that runs across the top of the brain, and eventually, it splits into two jugular veins extending down the neck and toward the heart.

Meningiomas that have grown into sinuses are very difficult to manage, and the earlier a surgeon operates, the better. This is because the surgery may require clipping or cutting the vessel, which can mean brain swelling or a fatal blood blockage.

Sometimes, a surgeon can open up the sinus and remove the tumor, then patch the area using the patient’s own tissues or artificial grafts. If the tumor has completely blocked a sinus, it’s safe to cut since the vessel is cut off and other pathways for blood flow have been found.

Behind the eyes: Meningiomas can grow on the sphenoid wing, a shelf of bone in the middle of the head behind the eye. Tumors located here can become involved with the visual nerves or surround a key artery. Surgery for tumors in this spot can be tricky and demand an experienced neurosurgeon.

In the base of the skull: Another challenging presentation is a skull base meningioma that grows near the foramen magnum, the large opening at the bottom of the skull where it intersects with the spinal column. Several critical blood vessels and nerves sit at the base of the skull. It is often important to have a multidisciplinary team to care for these tumors.

Radiation therapy can stop tumor growth, but it’s usually not a first-line treatment since it only works in about half of patients with meningiomas. The therapy can make future surgery more difficult.

Sometimes, a neurosurgeon will use radiation on small tumor remnants. It can also be an option for a patient who is too sick to have surgery. Most meningiomas do not respond to chemotherapy.