Surgical Removal of the Tumor (total — Partial) for Meningioma treatment in the Best Hospitals in the World
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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.
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.
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.
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.
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.
Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Epilepsy Surgery, Spinal Surgery 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 four high-tech operating rooms, in which more than 2,400 surgical interventions are performed annually. Surgery to treat tumors of the nervous system in childhood and adulthood is of particular interest to the department's specialists. In addition, the department's medical team has unique clinical experience in the surgical treatment of epilepsy, spinal pathologies and deformities, as well as neurovascular pathologies. The department's doctors have a perfect command of advanced surgical techniques, for example, navigational surgery, intraoperative neuromonitoring, hybrid surgical techniques, which are the basis of successful clinical practice. State-of-the-art computer-assisted systems allow neurosurgeons to plan each stage of surgical intervention as accurately as possible, thereby guaranteeing its high efficiency and safety.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers modern diagnostics and effective treatment of the full range of diseases, injuries, inflammatory processes, tumors and malformations of the brain, spinal cord and their meninges, as well as spinal diseases. Spinal surgery is performed in collaboration with doctors from the Department of Adult and Pediatric Traumatology, Orthopedic Surgery. The department admits adults and children with malformations of the nervous system, brain and spinal cord tumors, drug-resistant epilepsy and other diseases. As one of the largest medical facilities of this kind in Germany, the department's doctors annually perform more than 2,500 surgical interventions on the brain and spinal cord, peripheral nerve endings. The department's specialists also perform over 400 spinal surgical procedures annually. To achieve high success rates of the surgical treatment, doctors use the very latest equipment, including neuronavigation systems. Thanks to this, surgeons not only successfully eliminate the pathology, but also guarantee the patient maximum safety. The department has 78 beds, including 14 beds in the Intensive Care Unit. The priority goal of the department's medical team is to provide high-quality treatment focused on the patient's needs.
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.
Department of Neurosurgery and Spinal Surgery
The Department of Neurosurgery and Spinal Surgery provides top-class medical care for patients with diseases of the central and peripheral nervous systems. The medical facility performs surgery of any complexity on the brain, spinal cord, spine, and peripheral nerves. The department is the largest healthcare facility of this kind in Germany and has a team of highly professional neurosurgeons with long clinical experience. The department's specialists focus on patients with brain tumors (gliomas, meningiomas, and brain metastases), neurovascular diseases (aneurysms, arteriovenous malformations, and dural arteriovenous fistulas), and traumatic brain injuries. Spinal surgeons operate on patients with herniated discs, spinal canal stenosis, spondylolisthesis, spondylodiscitis, spinal fractures, and spinal tumors. The department extensively uses minimally invasive surgical techniques that allow for good therapeutic results with high safety in surgical manipulations. The medical facility has two hybrid operating rooms with state-of-the-art equipment, including the Zeego® intraoperative robotic angiography system and the intraoperative Brainsuite® MRI.
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.
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.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers the full range of modern services in this medical field. The high level of technical equipment in the department allows for the performance of all highly specialized surgical interventions to treat pathologies of the central and peripheral nervous system. The clinical practice mainly focuses on the diagnostics and surgical treatment of diseases, injuries of the brain, spine, spinal cord, intervertebral discs, nerve plexuses, functional neurosurgery and the treatment of neurosurgical pathologies in children.
Department of Adult and Pediatric Neurosurgery
The Department of Adult and Pediatric Neurosurgery offers all modern surgical interventions for the treatment of pathologies of the nervous system. The clinical focuses include the treatment of oncological diseases of the nervous system (neuro-oncology), skull base surgery, vascular neurosurgery, spinal surgery and functional neurosurgery, including the surgical treatment of epilepsy. As a state-of-the-art medical facility, the department has the advanced systems for deep brain stimulation, multimodal neuronavigation devices, intraoperative neuronavigation using CT, ultrasound systems, fluorescence imaging devices and endoscopy equipment. Thus, the department has all the possibilities to ensure effective treatment according to the international standards.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery specializes in performing surgical procedures of any complexity on the brain, spinal cord, spine, and peripheral nervous system in patients of all ages. The department's operating rooms are equipped with the latest technology to ensure the most effective and safe treatment of neurosurgical pathologies. During surgery, the department's specialists use innovative intraoperative neuromonitoring systems, neuronavigation devices, and continuous electrophysiologic monitoring systems. The department employs skilled neurosurgeons with extensive clinical experience and in-depth expertise, who prioritize effective treatment according to each patient's individual needs. The physicians strictly follow current clinical protocols and recommendations of the German Society of Neurosurgery (DGNC). It should be noted that the department is part of the Center for Neuro-Oncology certified by the German Cancer Society (DKG), has the status of a Center for Spine Surgery certified by the German Spine Society (DWG), and a Center for Skull Base Surgery certified by the German Society for Skull Base Surgery (GSB).
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of diagnostic examinations and surgical treatment of diseases of the central and peripheral nervous systems. The team of the department's neurosurgeons successfully performs operations for pathologies of the brain and spinal cord, spine, neurovascular pathologies, pituitary diseases, and epilepsy. The doctors specialize in surgery for malignant brain tumors. The department is part of the Gliome Competence Center Network and the German Cancer Aid. The department uses the latest minimally invasive microsurgical techniques, navigation systems, intraoperative systems, and other advanced technical resources that allow for an optimal therapy result. The department has 84 beds for its patients, 10 of which are intended for intensive care. Medical care is based on an individual approach with due consideration of the patient's specific clinical data and needs. The specialists working at the medical facility always devote enough time to personal communication with their patients and do everything possible so that they receive effective treatment and maintain a decent quality of life.
Department of Adult and Pediatric Neurosurgery, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery offers the full range of services in these fields and specializes in the surgical treatment of diseases of the brain and spinal cord, peripheral nervous system and spine. The important areas of the department's clinical activity also include neuro-oncology, vascular neurosurgery and pediatric neurosurgery. The treatment is provided in four state-of-the-art operating rooms equipped with all the necessary facilities. The department admits about 2,700 inpatients and 4,100 outpatients annually. The team of the department's neurosurgeons is distinguished by high professionalism, and performs many operations using sparing minimally invasive surgical techniques. Navigation systems, intraoperative monitoring devices, 5-ALA fluorescence are successfully used during the surgical treatment. Each operation is carefully planned using advanced navigation devices (under the guidance of CT and MRI scanning). In general, the department's surgeons annually perform more than 4,000 neurosurgical interventions, and therefore they are justifiably proud of their unique clinical experience and treatment results.
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:
- 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.
- 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.
- 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.
- 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.
- 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:
- 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.
- 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.
- 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.
