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Meningiomas are another primary brain tumour, which begin their growth from the cells that cover the brain. They generally push into the brain substance, occasionally invading it in the more malignant forms. These tumours can present with dysfunction of the brain, which is being pushed into quite commonly. They tend to grow slowly and commonly do not present with symptoms of raised pressure within the head. They also are diagnosed by using CT scanning and MRI scanning. The treatment options here again are quite variable. The diagnosis maybe certain enough on the CT or MR scanning that radiation treatment, now utilizing the Gamma Knife which has been installed at the Health Sciences Centre for very accurate dosing of radiation, maybe the primary therapy. Depending upon their location, these tumours are most commonly operated upon because a complete removal is by far the best and safest way of handling them. In many cases though, the removal must be incomplete, at which point subsequent radiation can be given to control further growth. These tumours are usually not amenable to chemotherapy.

Once again, following initial management, these patients are followed at the Manitoba Brain Tumour Clinic, which, in the case of meningiomas, will be usually for at least a decade. These tumours can recur late and follow-up is important.

Many meningiomas are discovered incidentally during work-up for other problems. Because these are slow growing tumours, if the patient is asymptomatic, a plan of observation is often utilized at the beginning. In elderly patients, it would be very common that these tumours would not need to be treated at all.

The Gamma Knife will revolutionize the treatment of these tumours, especially those in hard to reach places in the brain where the morbidity of surgery is often very significant. Surgeries can be planned in advance to remove as much tumour as necessary to separate functional brain from the tumours, following which the Gamma Knife can be used to treat the residual.

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