Abstract
With innovations in microneurosurgical techniques and equipment in the recent era, many difficult meningiomas can be removed completely in the hands of experienced neurosurgeons. Specific cranial base approaches provide a dissection technique focused on bone removal, rather than brain retraction, which is critical to the safe resection of deeply seated meningiomas. The surgical aim has focused not only on patients' survival but also on quality of life. Despite these advances, challenges remain in the treatment of meningiomas. Notable among these is the tendency of meningiomas to recur. Factors affecting the recurrence rate are age, sex, histology, location, and the modality of surgical treatment. Recurrence rates for benign meningiomas range from 4 to 52%. Volume of tumor removed and tumor attachment to neighboring tissues affect the recurrence rate. Magnetic resonance imaging is the most useful diagnostic tool in the detection of postoperative residual and recurrent tumor. Surgery remains the first option in the treatment of most recurrent meningiomas. Adjunctive treatments may be considered in selected cases.
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