Neurosurgeon says not every meningioma needs open brain surgery

Dr. Mohana Rao Patibandla says carefully selected meningioma patients may avoid open surgery by using stereotactic radiosurgery, a precise non-invasive option that can preserve function and control tumor growth. His internationally published research and hospital practice aim to help patients and families choose among surveillance, microsurgery, radiosurgery and combined treatment based on tumor details.

Why it matters: - Meningiomas are the most common primary brain tumor in adults, and many are benign and slow-growing. - A diagnosis of a brain tumor does not automatically mean open craniotomy is required. - For carefully selected patients, stereotactic radiosurgery can control tumor growth while avoiding an open operation and limiting recovery time. - Treatment choice can affect vision, hearing, balance, swallowing, memory and other neurological functions.

What happened: - Dr. Mohana Rao Patibandla, founder and chief neurosurgeon at Dr. Rao's Hospital – International Institute of Neurosciences in Guntur, Andhra Pradesh, explained why every meningioma does not require open brain surgery. - Dr. Rao highlighted research and clinical experience showing that stereotactic radiosurgery can be the right choice for selected brain tumors. - Dr. Rao trained in India and completed advanced fellowship training in the United States in stereotactic radiosurgery, minimally invasive neurosurgery, skull base surgery, pediatric neurosurgery, neuro-oncology and cerebrovascular/endovascular neurosurgery. - The hospital is based in Guntur and provides brain, spine and nervous system care through a multidisciplinary team.

The details: - Meningiomas arise from the meninges, the protective membranes around the brain and spinal cord. - Many meningiomas grow slowly over several years and may never cause symptoms. - MRI scans now detect many meningiomas incidentally during workups for unrelated headaches, dizziness or trauma. - Stereotactic radiosurgery is not traditional surgery. - The treatment uses multiple precisely focused radiation beams that converge on the tumor with sub-millimeter accuracy. - The approach does not require incisions, stitches or removal of bone. - Potential benefits include avoiding open surgery, shorter recovery, preserved neurological function and long-term tumor control. - Radiosurgery is not appropriate for every patient. - Treatment decisions depend on tumor size, growth rate, location, symptoms, age, general health and imaging findings. - Some patients do best with observation, some with microsurgery, and others with stereotactic radiosurgery. - In some cases, surgery followed by radiosurgery provides the best long-term outcome. - Tumor location can matter as much as, or more than, size. - Tumors in the skull base, posterior fossa, petroclival region or foramen magnum can sit near structures that control vision, hearing, facial movement, swallowing, balance and breathing. - Dr. Rao's internationally published research has focused on central skull base, posterior fossa, foramen magnum and petroclival meningiomas. - The research adds to evidence supporting individualized treatment for complex meningiomas. - Dr. Rao said the goal is not simply to remove tumors, but to choose the treatment most likely to control the tumor while preserving neurological function and quality of life. - Dr. Rao also said the most advanced treatment is not always the best treatment, and the right treatment is the one tailored to the individual patient. - Management options can include active MRI surveillance, microsurgical removal, stereotactic radiosurgery, fractionated radiotherapy and combined surgery plus radiosurgery. - Treatment planning may involve neurosurgeons, radiation specialists, neuroradiologists, neuropathologists and rehabilitation teams. - Warning signs that should not be ignored include headaches, double vision or vision loss, hearing changes, facial numbness or weakness, balance problems, new seizures, progressive limb weakness, and memory or personality changes. - Early diagnosis can help physicians monitor tumors and intervene before irreversible neurological injury develops. - Dr. Rao's published work in internationally recognized neurosurgical journals helps guide discussions about long-term outcomes, volumetric tumor assessment and management strategies for difficult tumor locations. - The research reported nearly 92% tumor control over 10 years in these meningiomas.

Between the lines: - The message reflects a broader shift in neurosurgery away from one-size-fits-all treatment and toward tumor-specific planning. - The emphasis on radiosurgery suggests many patients may be able to preserve function when surgery would create avoidable risk. - The research and fellowship training are being used to strengthen shared decision-making, not replace clinical judgment. - Advances in neuroimaging, AI-assisted treatment planning, stereotactic radiosurgery and minimally invasive neurosurgery are expanding options for benign brain tumors.

What's next: - Specialists expect increasingly personalized treatment strategies that better balance tumor control, risk reduction and quality of life. - Patients diagnosed with a meningioma are being urged to seek careful evaluation from an experienced multidisciplinary team rather than assume surgery is inevitable. - Dr. Rao's Hospital says it will continue offering advanced neurosurgery, stereotactic radiosurgery and related subspecialty care through its neurosciences center.