Investigation

In order to build up a picture of your brain, The London Clinic may offer the following:

CT scan: this machine takes a series of x-rays to build up a 3D image of your brain and the blood vessels around the tumour. It takes 10 minutes and is painless, and the radiation level used is very low. You should not eat or drink for four hours beforehand, and you may be given an injection of contrast to allow certain areas to show up more clearly under the CT scanner.

MRI scan: this is similar to a CT scan but uses magnetism rather than x-rays. It can be slightly uncomfortable and noisy, and some patients feel claustrophobic: it takes around 30 minutes. You cannot have an MRI if you have a pacemaker or any kind of metal implant in your body.

Treatment

Conservative treatment: if your meningioma is causing few or no symptoms, it may simply be monitored with interval MRI scans.

Surgery: when a tumour begins to cause symptoms, it usually has to be removed (excised). Peter Bullock and The London Clinic have particular experience in dealing with large meningiomas because their patients come from far and wide with tumours that are often quite advanced.

For all meningiomas, surgery effectively means opening a series of trapdoors first the scalp, and then the bones of the skull. The tumour is lifted out, the wound is closed and in the majority of cases, the patient is cured. You will probably be in hospital for around five to seven days.

Radiotherapy: if, because of its position, Peter Bullock cannot remove all of your meningioma with surgery, he may offer you stereotactic radiation treatment using Gamma Knife® or CyberKnife®, which delivers high-dose radiation with pin-point accuracy. Gamma Knife® treatment takes place at the Cromwell Hospital, west London, while CyberKnife® treatment takes place at The London Clinic. Peter Bullock is involved with both procedures.

Chemotherapy: most meningiomas are benign and those that are not, are usually treated with radiotherapy rather than with chemotherapy.

Follow-up: it’s usual to have MRI scans for five years once your meningioma has been removed, in order to check your progress. These can be performed at The London Clinic, or possibly closer to your home if travelling is an issue.