Meningioma

Meningiomas are generally benign slow growing tumours that arise from the cells that line the brain. Very occasionally these tumours can be malignant. Meningioma is one of the commonest brain tumours, and can sometimes occur at multiple sites.

The presenting symptoms depend on the location of the tumour and are caused by the tumour pressing on surrounding tissue or nerves. Patients can present with epilepsy, but pressure related symptoms, such as headache and vomiting can also occur.

Aims of Treatment:

Prevention of tumour growth (by gamma knife treatment)

Removal of tumour (by surgical excision)

Surgery

Surgery aims to remove the tumour and its origin completely without damaging the surrounding brain tissue, and remains the treatment of choice for easily accessible lesions. However, if removal is for some reason incomplete, then the tumour may recur. Some tumours are so awkwardly situated as to be considered inoperable, and these tend to be those that arise from the base of the skull, where they may be intimately related to nerves, blood vessels, or other vital structures. When complete removal is not possible patients can often go on to have gamma knife treatment to any residual tumour. This is also a particularly useful treatment pathway for larger tumours, or tumours producing neurological deficits due to their sheer bulk.

Gamma knife

Skull base lesions, and particularly those in relatively inaccessible sites such as the cavernous sinus, are particularly well suited to gamma knife treatment. Tumour control rates of up to 95% are generally quoted. Complications following gamma knife treatment, including nerve damage, have a low reported incidence - this compares favourably with surgery. Gamma knife can also be used to treat patients with multiple lesions.