Meningioma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: {HL}}

Overview

The predominant therapy for meningioma is surgical resection. Adjunctive radiation therapy may be required among certain patients.

Surgery

• The predominant therapy for meningioma is surgical resection. Adjunctive radiation therapy may be required among certain patients.
• Transarterial embolization has become a standard procedure in the preoperative management.
• Surgical resection procedures of meningioma include:

• Complete meningioma resection, with excision of any involved bone, venous sinuses and dural attachments.
• Complete meningioma resection and coagulation of dural attachment
• Partial meningioma resection sparing the dura
• Subtotal meningioma resection

• The Simpson criteria for meningioma correlates the degree of surgical resection completeness with the probability of symptomatic tumor recurrence:

Simpson Grade	Completeness of Resection	10-year Recurrence
Grade 1	Complete removal including resection of underlying bone and associated dura	9%
Grade 2	Complete removal and coagulation of dural attachment	19%
Grade 3	Complete removal without resection of dura or coagulation	29%
Grade 4	Subtotal resection	40%

• Surgical resection is not recommended among patients with asymptomatic stable meningioma.
• Surgical resection is not recommended among patients with advanced meningioma which invades the surrounding bone.

References

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