Meningiomas

Research shows that hospitals performing a high volume of meningioma operations (more than 10 per year) report fewer deaths than lower-volume hospitals – and that outcomes are better with high-volume neurosurgeons (those who perform more than seven operations per year). For the past five years, UT Southwestern Medical Center neurosurgeons have operated on more than 60 meningioma patients per year. 

Our neurosurgeons are supported by a team of physicians and nurses equally experienced in the management of these tumors.

Symptoms and Diagnosis for Meningioma

Because meningiomas can occur in many locations within the skull, they can produce a variety of neurologic problems. Large tumors in any location can cause headaches. Tumors that irritate the surface of the brain can produce seizures. Tumors that involve one or more of the cranial nerves can produce loss of function of those nerves – loss of vision or hearing, for example.

Many small meningiomas are discovered by chance imaging tests, before they have caused any symptoms or problems. In most cases, these incidental meningiomas are observed with MRI scans and not treated unless they show evidence of growth. Meningiomas that produce symptoms are evaluated by a team of neurosurgeons to determine the best management for each patient. 

Meningiomas are classified into three groups:

• Grade 1: Benign, approximately 70 percent
  
• Grade 2: Cells that demonstrate aggressive growth potential, approximately 29 percent
  
• Grade 3: Malignant, 1 percent

Treatment for Meningioma

When a meningioma develops over the surface of the brain, it’s usually possible to remove it completely, but many meningiomas involve important arteries, veins, or cranial nerves. In these cases, a complete removal could be hazardous. In these instances, surgery often is combined with some form of radiation to control the remaining tumor.

Surgery

When treatment is needed, the best option for all grades is complete surgical removal, when possible. If a complete removal is not possible, the remaining tumor is, in some cases, monitored with magnetic resonance scans. In other cases, especially for grade 2 or 3 tumors, remaining tumor fragments are treated with some form of radiation after the patient has recovered from surgery.    

Radiation Therapy

For meningiomas that cannot be completely removed and, in some cases, as an alternative to surgery, UT Southwestern offers access to the most accurate radiation delivery technology available. 

We have the only Gamma Knife Icon in the Dallas–Fort Worth Metroplex, and whenever possible we use this device to treat recurrent or residual tumors on an outpatient basis. 

We treat larger tumors or those that contact the optic nerves with the CyberKnife, a robotic device that maintains accurate radiation delivery for treatments that must be delivered in divided doses, over several days or weeks. Radiation oncologists and neurosurgeons who are highly experienced in the treatment of meningiomas plan radiation treatment jointly.