Meningioma

Understanding Meningioma

Although the majority of meningiomas are non-cancerous, their growth inside the rigid skull inevitably compresses surrounding brain structures. Over time, a slowly expanding tumour can press against the cerebral cortex, cranial nerves, or venous sinuses, producing neurological symptoms that worsen as the tumour enlarges. The challenge with meningioma is that by the time a patient notices symptoms, the tumour may have been present and growing for a decade or more.

Early specialist evaluation transforms the outlook: small tumours caught before they cause permanent damage offer far more treatment options, shorter recovery times, and higher success rates. For patients diagnosed overseas, Istanbul provides access to world-class meningioma expertise with waiting times measured in days rather than months.

Symptoms of Meningioma

Meningioma symptoms vary widely depending on the tumour's size and location within the skull. The most common symptoms include persistent or worsening headaches (often worse in the morning), seizures in patients with no prior history of epilepsy, vision changes including blurring or loss of peripheral vision, weakness or numbness in the arms or legs, memory loss or difficulty concentrating, changes in personality or mood, and hearing loss or tinnitus for tumours near the acoustic nerve.

Many small meningiomas are discovered incidentally during imaging performed for unrelated reasons and cause no symptoms at all. These cases are often managed with active surveillance rather than immediate intervention.

Diagnostic Pathways

MRI with contrast enhancement is the definitive imaging modality for meningioma. These tumours have a characteristic appearance on contrast-enhanced MRI, with a homogeneously enhancing mass and a "dural tail" sign. Most meningiomas can be diagnosed by imaging alone without a biopsy.

CT scanning is used to evaluate calcification within the tumour, which is common in meningiomas, and to assess bone involvement or hyperostosis of the overlying skull.

Angiography or MRA may be used to assess the tumour's blood supply, particularly for large or skull base meningiomas where preoperative embolisation may reduce surgical bleeding.

Pathological grading is performed when tissue is obtained through biopsy or surgical resection. The WHO classification grades meningiomas from Grade I (benign) to Grade III (malignant), which determines the subsequent treatment strategy and surveillance protocol.

Advanced Treatment Options at Vellum Select

The optimal treatment for meningioma depends on tumour size, location, WHO grade, patient symptoms, and overall health. Vellum Select offers the full spectrum of meningioma management through Prof. Dr. Türker Kılıç, one of the world's most experienced meningioma surgeons.

Gamma Knife Radiosurgery

For small to medium-sized meningiomas (typically under 3 cm) that are either asymptomatic or causing mild symptoms, Gamma Knife Radiosurgery is often the preferred approach. Gamma Knife uses 192 focused radiation beams to arrest tumour growth with sub-millimetre accuracy, requiring no incision and no hospital admission. Tumour control rates for Grade I meningiomas exceed 95% at 5 years. The procedure is performed as a single outpatient session, and most international patients return home within 48 hours.

Craniotomy and Microsurgical Resection

For larger meningiomas causing significant mass effect or neurological symptoms, or for tumours accessible enough for complete removal, Brain Tumour Surgery (craniotomy) remains the gold standard. Prof. Dr. Kılıç's microsurgical technique aims for complete resection (Simpson Grade I or II), which offers the lowest recurrence rates. Post-operative Gamma Knife is often used to treat any residual tumour at the skull base, combining the strengths of both approaches.

Active Surveillance

Small, asymptomatic meningiomas in elderly patients or those with significant surgical risk may be managed with serial MRI monitoring. Prof. Dr. Kılıç defines individualised surveillance intervals based on tumour growth rate and patient factors, ensuring intervention is recommended only when the benefit clearly outweighs the risk.

To discuss your meningioma diagnosis with Prof. Dr. Türker Kılıç, view his profile or contact Vellum Select to arrange a consultation.