Brain Meningiomas are one of the commonest brain tumors and arise from the dura which is the covering of the brain and progressively compress the brain and its blood vessels/nerves as the tumor grows. Sometimes, brain meningiomas also start encasing crucial blood vessels of the brain or invading main blood drainage venous channels of the brain. Most meningiomas are benign and non-cancerous.
By virtue of the fact that meningiomas are mostly benign and do not arise from the brain and just compress the brain, they are the better brain tumors.
However, surgical excision of meningiomas is actually technically more challenging than surgery for say cancerous brain tumors because meningiomas need to be removed completely to reduce the chances of recurrence and the underlying brain with its blood vessels/nerves need to be completely preserved to avoid post-operative neurological complications.
Small meningiomas without significant brain compression can be managed with either a Wait and Watch policy or Radiosurgery. However, follow-up MRIs would be required to see for increase in tumor size.
Traditional surgical technique-
Most surgeons core out the inside part of the Brain Meningioma using an Ultrasonic Aspirator and thereafter dissect the shell of the tumor away from the brain/nerves/blood vessels, finally removing the shell of the tumor.
Meningiomas are Curable -Living a normal life with a Normal life expectancy following successful surgery - Dr Sujoy K Sanyal’s Curative Enbloc excision Approach
I prefer to excise Brain Meningiomas en-bloc as one piece. This decreases intra-operative blood loss/surgical time/brain dissection, decreases the chances of recurrence almost to nil, and gives the best neurological outcome due to least brain handling. Patients and their families are also pleased to see the tumor removed as a single en-bloc piece at the end of surgery. It takes the dread out of Brain tumors to see the tumor tackled in one piece and a fast-recovering patient.
