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Surgical Removal of the Tumor (total — Partial) for Meningioma treatment in the Best Hospitals in the World

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of accurate diagnostics and surgical treatment of diseases of the central and peripheral nervous system. The department's surgeons annually perform over 5,000 surgical interventions, which indicates their high professionalism and tremendous experience. The key attention is paid to the treatment of cerebrovascular diseases, diseases of the spine and spinal cord, brain and skull base tumors, peripheral nerve lesions, cerebrospinal fluid circulation disorders, as well as pain therapy (functional neurosurgery). The treatment of neurosurgical diseases in children and adolescents is carried out by a specially trained team of experts.

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Memorial Bahcelievler Hospital Istanbul

9.2/10
location_onTurkey, Istanbul

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the nervous system according to the highest international standards. The department's doctors specialize in the surgical treatment of pathologies of the brain and spinal cord, as well as diseases of the peripheral nerves. The department's medical team provides its services to patients of all age categories – from young children to the elderly. The department has high-tech operating rooms, where endoscopic and microsurgical interventions are successfully performed, ensuring the fastest recovery and excellent treatment results. For maximum safety of surgical treatment, the doctors widely use in their clinical practice cutting-edge neuromonitoring and neuronavigation systems, intraoperative CT O-Arm, intraoperative ultrasonography and other technologies.

University Hospital HM Monteprincipe Madrid

9/10
location_onSpain, Madrid

Department of Neurosurgery

The Department of Neurosurgery offers the full range of modern surgical treatment of diseases of the nervous system. The department's neurosurgeons have rich experience and technical options for both simple routine and especially complex interventions on the brain and spinal cord. To achieve the best treatment results, there is maintained productive cooperation with the specialists in oncology, neurology and interventional neuroradiology. The state-of-art navigation systems and computer equipment available in the department allow the surgeons to perform the most accurate manipulations, while preserving healthy tissues and vital functions of the nervous system.

University Hospital for Neurosurgery Salzburg

9.6/10
location_onAustria, Salzburg

Department of Neurosurgery

University Clinic of Neurology specializes in the surgical treatment of acute and chronic diseases of the central and peripheral nervous system, its blood supply, and nerve sheaths, as well as in preoperative and postoperative care for patients.

University Hospital Freiburg

9.7/10
location_onGermany, Freibung

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of surgical treatment of diseases of the brain, spine, spinal cord and nerves in adults and children. The department keeps pace with new trends in medicine, as well as contributes significantly to their development. Therefore, the most modern diagnostic and therapeutic methods are available here. An individual approach to each clinical case is crucial to ensure optimal treatment results with the preservation of all neurological functions.

Tel Aviv Sourasky Medical Center

9.9/10
location_onIsrael, Tel Aviv

Department of Neurosurgery

The Department of Neurosurgery offers the widest range of diagnostic examinations and therapeutic methods for patients with diseases of the brain, spinal cord and peripheral nervous system. The department is considered the leading Neurosurgical Center in Israel and around the world.When treating patients, the doctors apply all available medical innovations and adhere to the highest international standards.

Primus Super Speciality Hospital New Delhi

9/10
location_onIndia, New Delhi

Department of Adult and Pediatric Neurosurgery, Neurology

The Department of Adult and Pediatric Neurosurgery, Neurology offers the comprehensive diagnostics, conservative and surgical treatment of diseases of the nervous system. The tasks of the department's doctors also include rehabilitation of patients with neurological pathologies. Thanks to the modern infrastructure and the progressive equipment of the department, most operations can be performed using sparing minimally invasive techniques. In addition, the surgical treatment involves the use of neuromonitoring systems, which increases the safety of interventions in functionally important areas of the brain.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Neurosurgery

According to the Focus magazine, the Department of Adult and Pediatric Neurosurgery ranks among the top German medical facilities specializing in the surgical treatment of brain tumors! The department offers the full range of diagnostics and surgical treatment of diseases of the central and peripheral nervous system. A specially trained team of pediatric neurosurgeons provides treatment for various neurosurgical pathologies in children. During the treatment, the doctors use state-of-the-art equipment, in particular, imaging-guided neuronavigation, functional imaging (fMRI), intraoperative mapping, intraoperative videoangiography, etc.

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the accurate diagnostics and effective treatment of the entire spectrum of neurosurgical diseases, injuries, inflammations, tumors and malformations of the brain, spinal cord and their meninges, as well as the spine. As one of the largest medical facilities of its kind in Germany, the department performs more than 2,500 surgical interventions every year. The department has 78 beds, including 14 beds in the intensive care unit. The priority goal of the specialists is to provide patient-oriented, high-quality medical care, as well as the study of neurosurgical diseases, the development of new therapeutic methods and the training of medical students.

University Hospital Carl Gustav Carus Dresden

9.1/10
location_onGermany, Dresden

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of diagnostics and surgical treatment of diseases of the brain, spinal cord and peripheral nerves at the highest international level of modern medicine. The department has at its disposal three high-tech operating rooms, in which more than 2,000 surgical interventions are performed annually. Of particular interest of the department’s specialists is surgery of tumors of the nervous system in childhood and adulthood. The department has at its command the advanced surgical techniques, for example, navigation surgery, intraoperative neuromonitoring, hybrid surgical techniques that are the basis of the department’s successful clinical practice.

University Hospital Hamburg-Eppendorf

9.2/10
location_onGermany, Hamburg

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the diagnostics and comprehensive treatment of neurosurgical pathologies, including tumors of the central and peripheral nervous system. The department is the leading Center of Neurosurgery in Northern Germany and is responsible for the implementation of new algorithms for the treatment of patients with brain tumors. To this end, there is an active participation in the international researches and the development of new surgical methods, for example, operations in the waking state. Close interdisciplinary cooperation also contributes to the achievement of optimal treatment results.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Neurosurgery

The Department of Neurosurgery offers the full range of surgical interventions for the treatment of diseases of the central and peripheral nervous system. The department is one of the largest medical institutions of this kind in Germany. The doctors of the department provide patients with the high-quality medical care of university level, and also take an active part in the experimental fundamental studies and clinical trials to develop new treatment methods.

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the diagnostics and treatment of the entire spectrum of neurosurgical diseases. The department specializes in the treatment of brain tumors, vascular diseases and intracerebral hemorrhages, spinal diseases, deep brain stimulation, etc. Special competence lies in the field of pediatric neurosurgery. The department offers the very latest highly accurate and minimally invasive treatment methods.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the full range of diagnostics and treatment of diseases of the central and peripheral nervous system. The medical institution occupies a leading position in this sector in Europe. The neurosurgeons of the department have at their disposal four high-tech operating rooms, in which more than 3,500 interventions are performed annually. Active clinical and experimental research activities, as well as close cooperation with national and international reputable research centers, promote the introduction of innovative treatment techniques that are available only in a few clinics in the world.

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Neurosurgery

The Department of Neurosurgery offers the full range of surgical treatment of diseases of the nervous system and belongs to the largest medical facilities of this kind at the national level. The department has 4 state-of-art operating rooms where more than 2,700 interventions are performed annually. It has the progressive surgical equipment, for example, intraoperative monitoring, neuronavigation, tools for performing minimally invasive operations, which provide the most effective and reliable therapy. The department has earned the reputation of the Center of Competence in the field of tumor surgery of the nervous system and spine.

University Hospital Essen

9.6/10
location_onGermany, Essen

Department of Adult and Pediatric Neurosurgery

The Department of Adult and Pediatric Neurosurgery offers the widest range of surgical interventions for the treatment of diseases of the central and peripheral nervous system, including stereotactic surgery and endoscopy. With more than 2,400 operations every year, the department has a unique experience, which allows it to provide the high-quality medical care even in extremely complex clinical cases. The key focus of the department is pediatric neurosurgery. In addition to the high professionalism of doctors, the treatment success is facilitated by exclusively advanced medical equipment, for example, neuronavigation systems and intraoperative fluorescence navigation.

Meningioma is one of the most common tumors of the central nervous system. It can occur in different parts of the brain and typically grows from the arachnoid membrane. The tumor is fused to the dura mater and bone. In most cases, meningiomas are benign and grow slowly, so they do not reach large sizes and are successfully treated with surgery. In most cases, the surgical removal of meningioma is the curative intervention that leads to the complete recovery. Relapses of bening meningiomas are extremely rare.

Principles of meningioma treatment

Surgery and radiation therapy are used for meningioma treatment. Chemotherapy is rarely used because in most cases, meningioma demonstrates low sensitivity to drugs.

Surgery is used as the first-line treatment method for most patients. Radiation therapy without surgery is used much less frequently. This therapeutic tactics is suitable in the following cases:

  • Location of the tumor inconvenient for its surgical removal – if the removal of meningioma is dangerous for the patient and can cause severe neurological deficit
  • Poor general health state of the patient associated with both meningioma and concomitant diseases
  • Refusal from surgical intervention

Radiation therapy gives the best results when the diameter of the brain tumor is under 3,5 cm. It ensures at least stabilization of the tumor size, and in many patients it reduces size of the neoplasm. Irradiation is safer but less effective than surgery. Radiation therapy does not always cure the disease and may not eliminate all symptoms. In patients, who received radiation without surgery, neurological disorders regress more slowly. Thus, irradiation can’t be the first-line option in patients with aggressive meningiomas that grow fast and are life-threatening.

The purpose of surgery

The main goals of meningioma surgery are as follows:

  1. Removal of brain tumor, as radical as possible. Radicality of surgery is assessed according to the Simpson grade, from 1 to 5. If possible, the neurosurgeon aims to remove the tumor along with the dura mater and bone, or to coagulate the matrix – the place from which the meningioma grows initially.
  2. Preservation of nerves and functionally important areas of the brain. It is important that neurological disorders regress after surgery. During the removal of tumor, the doctor seeks to minimize damage to healthy brain tissues, so as not to exacerbate the neurological deficit.
  3. Cure of the disease. In most cases, it is possible in benign meningiomas. Additional radiation therapy is sometimes required for complete cure or prolonged remission.
  4. Increased life expectancy. If a complete cure of the pathology is impossible, the doctors strive to achieve the greatest possible recurrence-free period and life expectancy. Most of the recurrences occur in intermediate and malignant meningiomas. Such types of neoplasms require more careful follow-up after the completion of main treatment.
  5. Elimination of symptoms. Some patients undergo non-radical surgeries – decompression and dilatation of the dura mater.

How is the operation performed?

Brain surgery is performed in the Department of Neurosurgery. General anesthesia is used for pain management. The doctor performs osteoplastic craniotomy, dissects the dura mater, coagulates or ligates blood vessels, depending on their caliber.

Meningiomas can vary in size, location, density, and grade. Therefore, operations in different patients are not the same. Ideally, the doctor removes not only the brain tumor, but also the adjacent part of the dura mater and bone, or coagulates the matrix (growth area of the meningioma) with a laser in order to avoid continued growth of the tumor after surgery. The removed structures sometimes have to be reconstructed from autologous (patient's own) tissues or artificial materials.

Neuronavigation systems, surgical microscopes, and microsurgical techniques are used for removal of meningiomas in a hard-to-reach place. Modern equipment allows the doctor to avoid haemorrhage, damage to large nerves and functionally important areas of the brain. In the best hospitals of the world, operations for removal of meningiomas are not only effective, but also safe for health.

Results of the surgery

The results of the operation for removal of meningioma of the brain are assessed according to the Simpson grade from 1 to 5, where:

1 – total removal of the brain tumors, resection of the pathologically altered bone (hyperostosis) and the dura mater (matrix)

2 – total removal of meningioma of the brain without bone resection, without removal of the dura mater, but with coagulation (destruction) of the matrix

3 – complete removal of the brain tumor without involving the matrix

4 – partial removal of the brain meningioma

5 – decompressive craniectomy, releasing compressed nerves, expanding plastic surgery of the dura mater

1-2 grade surgery according to the Simpson scale is considered total. After the operation, the remains of the brain tumor are not determined macroscopically. After total removal, meningioma rarely recurs or continues to grow.

Other operations are called subtotal. Recurrences are possible after them, if additional treatments are not used.

Is additional treatment necessary?

The need for additional treatment after meningioma surgery depends primarily on the following factors:

  • Grade of the brain tumor
  • Radicality of its removal
  • Patient's health state – whether he can tolerate additional treatments

Chemotherapy for meningioma is not used in most hospitals. Radiation therapy is used for prevention of recurrences.

Depending on the degree of malignancy of the meningioma, the following medical tactics are applied:

  1. Benign tumor accounts for about 77% of all cases of the disease. Benign neoplasms are usually small in size, as they grow very slowly. They can be removed totally, but even in the case of partial removal, recurrences occur rarely. As a rule, the patient stays under medical supervision and undergoes MRI or CT examinations on the regular basis. Irradiation is indicated only in the case of recurrence of neoplasm.
  2. Atypical meningioma is diagnosed in 22% of patients. To cure the disease, the total removal of the tumor is required. If it is not completely removed, or the matrix (growth area) is preserved, additional radiation therapy is performed.
  3. Anaplastic meningioma accounts for only 1% of cases. Such meningiomas almost always recur after resection. Radiation therapy is required even if the surgery has managed to remove the tumor completely.

Why is it better to treat meningioma abroad?

Meningioma surgery is very complicated and not always successful. The tumor is often located in inconvenient places for removal, attached to the dura mater and bone. Meningioma often becomes very dense due to its ossification. Excision of the tumor is usually accompanied by intense bleeding, which leads to blood loss and complicates the work of the surgeon. The operation often has to be complemented by a reconstruction stage – for example, the restoration of the upper sagittal sinus.

This is what the wrong choice of hospital can lead to:

  • Insufficient volume of tumor resection and, as a result, continued growth or recurrence of meningioma
  • Damage to nerves, functionally important areas of the brain, as a result – severe neurological deficit, poor quality of life after surgery
  • Severe haemorrhage during surgery or during the postoperative period with a risk to life

To cure the disease and avoid complications, many patients go abroad. In large foreign hospitals, the treatment is carried out by experienced world-renowned neurosurgeons. They use the latest equipment for neuronavigation, destruction and removal of tumors, prevention of haemorrhages.

Treatment abroad has the following benefits:

  • High-quality preoperative and intraoperative diagnosis, which allows the doctors to maintain good blood supply to the brain and avoid damage to functionally significant areas
  • The use of the latest neuronavigation systems allows the surgeon to choose the best surgical access, remove meningioma completely with minimal bone resection, without damaging important nerves and vessels
  • Minimally traumatic removal of hard-to-reach meningiomas using laser technology
  • In most cases, the doctors manage to remove 1 or 2 grade meningioma according to the Simpson scale, so the risk of recurrence or continued tumor growth is minimal
  • Embolization of vessels with microemboli is performed in foreign hospitals in order to reduce the risk of severe haemorrhage, if the tumor receives blood supply from the large vessels
  • Affordable cost of treatment. You can go to one of the countries with low prices for medical services in order to save money (Thailand, India, Turkey), or choose the best ratio of the cost of treatment and its quality (Germany, Spain, Israel)

If necessary, the patient can undergo a course of irradiation after surgery abroad. The latest stereotaxic devices and linear accelerators provide accurate irradiation of the tumor from different angles, with minimal health consequences. Neurological rehabilitation often starts after the main therapy completion.

Treatment abroad with Booking Health

To undergo treatment abroad at an affordable price, you can use the Booking Health service. The best hospitals in the world are presented on our website. Here you can find the information about hospitals, doctors, and therapeutic methods, as well as compare the cost of treatment for meningioma in different medical facilities and book the medical program at the best price.

The Booking Health company will arrange medical treatment abroad for you. We provide the following services and benefits:

  • Selection of the hospital, which specializes in meningioma surgery and performs the operation as safely as possible for the patient's health
  • Direct communication with the doctor
  • Reduced waiting period for a treatment and making an appointment for surgery on the convenient date
  • Reduced cost of treatment abroad – prices are lower due to the absence of coefficients for foreign patients
  • Relevant information about your expenses, the cost of procedures, funds remaining in your account
  • Elaboration of the treatment program for brain tumor without repeating previously performed diagnostic tests
  • Сommunication with the hospital upon the medical program completion
  • Buying and forwarding medicines
  • Organization of additional diagnosis making procedures or treatment abroad

The specialists of Booking Health provide high-quality services. We will book a hotel and airline tickets for you, organize a transfer from the airport to the hospital and back.




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