Surgical Removal of the Tumor (total — Partial) for Meningioma in Germany
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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, Spinal Surgery
The Department of Adult and Pediatric Neurosurgery, Spinal Surgery provides a full range of services in its areas of expertise. The department's doctors operate on patients with brain and spinal cord tumors, central nervous system malformations, epilepsy, traumatic brain injuries, degenerative disc diseases, spinal stenosis, spinal cord injuries, and peripheral nervous system pathologies. Neurosurgeons specialize in treating patients of all ages, including children and adolescents. Pediatricians, pediatric oncologists, radiologists, and neuroradiologists are involved in the treatment of young patients. Surgical procedures to treat pathologies of the nervous system are performed by highly qualified surgeons with extensive clinical experience. The physicians use state-of-the-art equipment in their work: intraoperative imaging systems, neuronavigation devices, and fluorescence imaging. Advanced technologies are key to effective and safe treatment, as damage to vital anatomical structures of the brain or spinal cord may cause severe neurological deficits. More than 2,000 operations are performed annually in the department's state-of-the-art operating rooms, the majority of which are for brain tumors. The department treats more than 11,000 patients each year. For many years, it has been one of the leading neurosurgical centers in Germany that treats patients from many European countries.
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 a brain tumor that grows from the arachnoid membrane. Surgical treatment of meningioma is the first-line therapeutic option. Since meningiomas are mostly benign and small, the disease can usually be cured completely. It is important to avoid worsening of the neurological deficit and developing serious complications after the intervention. In order to make the treatment effective and safe, you can undergo it in Germany.
Who needs surgical treatment for meningioma?
Surgical treatment of meningioma is the main method of managing the disease course and symptoms. The operation is indicated for all patients with this pathology. Radiotherapy is sometimes performed after it.
Some tumors cannot be treated with surgery. These are small meningiomas that are located in the hard-to-reach regions. In this case, stereotactic radiotherapy is used to suppress the tumor growth.
Some patients have contraindications for surgical treatment of meningioma. Some patients refuse the operation. In such situations, radiation therapy becomes the main method of treatment. It can reduce or stabilize the tumor growth.
What is the aim of the surgical treatment of meningioma?
The meningioma can be treated surgically for different purposes, including:
- Complete cure of the disease
- Removal of part of the tumor to stabilize the patient's condition
- Relief of symptoms and prevention of fatal complications
- Improving the patient's quality of life
- Increasing the life expectancy
When achieving the aims, the healthcare professionals pay attention to not harming human health, not causing significant neurological deficits or mental disorders due to damage to healthy tissues of the central nervous system.
If possible, the doctor removes the entire neoplasm so that the disease does not return after treatment. If the total surgical removal of a meningioma is life threatening or can aggravate neurological deficit, the doctor shifts to the partial resection (removing a part of the tumor).
Peculiarities of the surgical treatment of meningioma
Meningioma has certain features that distinguish it from other brain neoplasms. It is often benign and grows slowly. The tumor is connected to the dura mater and bone. Its borders are usually distinct, most meningiomas have a capsule.
Success of the surgical treatment of a meningioma depends on a number of factors:
- Location of the tumor
- Degree of tumor malignancy
- Size of the neoplasm
- Density of the meningioma (some tumors become very dense due to ossification)
- Patient's health condition and neurological status
The surgical treatment of meningioma can be technically challenging, so the operation must be performed in a well-equipped neurosurgical department, by experienced specialists. With a location of the tumor in the hard-to-reach region, there is a high risk of damaging large vessels with severe bleeding, as well as damaging cranial nerves, and functionally important areas of the brain.
How is surgical treatment performed
The patient undergoes a preoperative examination. In addition to standard procedures aimed at assessing general health state, an MRI or CT scan of the brain is required. In Germany, doctors use magnetic resonance spectrography, angiography, and functional MRI before surgical treatment of a meningioma. These tests help to determine the type of tumor, the peculiarities of its blood supply, and the location of functionally important areas of the brain.
Surgical treatment of meningioma requires general anesthesia. The doctor performs osteoplastic craniotomy. The maximum possible volume of the tumor is removed. In Germany, a laser is often used in the surgical treatment of meningioma. With the help of a laser the neurosurgeon cuts dense tissues and coagulates the matrix (the part of the dura mater from which the meningioma grows).
Removal of the tumor is often complicated by severe bleeding. To avoid blood loss, the doctor can perform the embolization of large vessels before starting the operation. During the surgical treatment of meningioma, the surgeon ligates and coagulates the arteries and veins.
After removing the tumor, the doctor closes the defect in the dura mater and bone using the patient's own tissues or artificial materials. In the postoperative period, MRI or CT scan is performed to reveal possible complications, assess the results of the operation and the degree of cerebral edema.
Neuronavigation and intraoperative diagnostics
If the tumor is located in the hard-to-reach region (e.g. a meningioma of the base of the skull), neuronavigation is required to remove it surgically with minimal risk of complications. In Germany, the latest equipment is used that allows visualizing the brain directly during surgery, without using a stereotaxic frame.
Neuronavigation allows the following:
- Choosing the best surgical approach
- Reducing the patient's preoperative preparation
- Determining bone marks
- Avoiding the excessive bone resection
- Detecting vessels and nerves that are impossible to identify visually
- Reducing the risk of damage to large arteries, veins, and cranial nerves
During the surgical treatment of meningioma, German doctors identify functionally important areas of the brain. This is required to avoid their damage. Functional mapping and electrophysiological tests are carried out in Germany to improve the safety of the operation.
Operation results
The results of surgery are assessed using the Simpson scale and are numbered from 1 to 5. Their meaning is as follows:
1 — complete removal of the meningioma along with a part of the dura mater and pathologically altered bone
2 — complete removal of the tumor with coagulation of the matrix (the area from which it grows)
3 — complete removal of the meningioma without involvement (removal or coagulation) of the zone of its growth
4 — partial removal of the tumor
5 — decompression craniotomy
Operations 1 and 2 according to Simpson scale are considered total removal of the meningioma. They provide the best results. Other surgical procedures are considered subtotal. If the tumor cannot be removed completely, doctors use radiation therapy to avoid its continued growth.
The effectiveness of surgical treatment of meningioma depends not only on the skill of the surgeon, but also on the degree of malignancy of the neoplasm.
Most tumors are benign. The risk of their recurrence after surgery is 15% during 10 years. If the meningioma is removed totally, the probability of recurrence is reduced to 4% over the same follow-up period.
About 1 of 5 patients develops an atypical (grade 2) meningioma. This tumor recurs with a probability of 30% during 3 years, 38% during 5 years of follow-up.
Anaplastic meningioma has the worst prognosis. It develops in about 1 in 100 people with such diagnosis. After performing a total tumor resection, the five-year survival rate reaches 22%. Unfortunately, it is not possible to perform the operation in the optimal volume in all patients. The overall risk of recurrence during 3 years of follow-up is 98%.
The additional treatment
The additional treatment includes radiation therapy. It is necessary to stop the growth of the tumor and / or to reduce the risk of its recurrence.
Clinical situations, when radiation therapy is indicated, depend on the degree of the meningioma malignancy:
- Grade 1 — radiation therapy is not required, even if the operation is not performed in an optimal volume. The patient stays under medical supervision. The tumor is irradiated only if it grows.
- Grade 2 — radiation therapy is not performed with the total removal of the meningioma, but is necessary in all cases when the doctor was unable to perform resection 1 or 2 according to Simpson scale.
- Grade 3 — radiation therapy is always required, even with optimal meningioma removal.
Irradiation is performed once the patient has recovered. Radiation therapy is usually planned no earlier than in 4 weeks after the surgery.
The safest type of radiation that is available in Germany is proton therapy. Despite the high cost of treatment, it is preferable for meningiomas of the base of the skull and is often used in children.
Why is it better to treat meningioma in Germany?
German doctors carry out surgical treatment of meningioma more effectively and safely compared to the healthcare specialists from other countries. Here are several reasons to travel to Germany.
1. High-precision examinations for the diagnosis making. This allows doctors to determine the type of tumor, its location and shape even before the surgery. Doctors receive information about the blood vessels feeding the meningioma, located near it anatomical structures and functionally important areas of the brain.
2. Well-equipped hospitals. During the surgical treatment of tumors of the central nervous system, German doctors use modern operating microscopes, assisting equipment, and neuronavigation systems. Intraoperative diagnostics is also performed, if necessary.
3. Safety of the surgeries. Doctors in German hospitals do not strive to remove the meningioma at any cost. They pay attention to avoiding damage to large nerves, blood vessels and functionally important areas of the brain, so as not to cause severe neurological deficit and worsen the quality of patients’ life.
4. Complete cure of the meningioma. In the majority of cases, doctors in German hospitals remove the meningioma completely, together with a matrix and a part of the affected bone.
5. The latest types of radiation therapy. If radiation therapy is required after the operation, in German hospitals it is carried out using modern linear accelerators. They provide irradiation of the tumor from different angles, accurately repeating its configuration and sparing healthy tissues.
In German hospitals, the cost of treatment may be higher than in the patient's native country. Nevertheless, the high prices for the services of German doctors are quite reasonable, because in Germany you can fight the disease with minimal health risks.
Meningioma treatment in Germany with Booking Health
In order to undergo surgical treatment of meningioma, you can travel to Germany. You may use the Booking Health service to find the reliable information about hospitals, doctors, prices, methods of treating brain tumors, etc. In addition, you may compare the cost of treatment in different hospitals and book a medical program at the best price.
Booking Health will organize your trip to Germany. Services and benefits of the Booking Health company include:
- Choosing a hospital that specializes in the surgical treatment of meningioma and performs the operation safely
- Direct communication with a neurosurgeon who will perform surgical treatment of meningioma
- Reducing the waiting time for treatment start and making an appointment at a convenient date
- Reducing the cost of treatment in Germany; prices are reduced due to excluding the additional coefficients for foreign patients
- Reliable information about your expenses, the cost of individual procedures, funds remaining in the account
- Preparation of a treatment program for surgical treatment of meningioma without the need to repeat previously performed diagnostic procedures
- Communication with the hospital after the completion of the medical program
- Purchase and sending of drugs
- Organization of additional diagnostics and treatment abroad, if necessary
Booking Health specialists provide high-quality service. We will book a hotel and airline tickets for you, organize a transfer from the airport to the hospital and back.