Life After Benign Meningioma Surgery

Discomfort after meningioma surgery varies from person to person. Some symptoms are relatively common and expected, while others may be less frequent or specific to individual people.

Common discomforts after meningioma surgery:

• Headache: Headaches are fairly common with meningioma, and some people may continue to have them after surgery. Although they usually improve over time. A study of 69 people with meningioma found that larger tumors showed higher rates of headache improvement after surgery, providing promising results for the surgical treatment.
• Fatigue: Surgery can cause temporary fatigue and weakness, which gradually improves during the recovery period.
• Nausea and vomiting: Some people may feel nauseous or vomit after surgery, but medications can help manage these symptoms.
• Incision pain: Pain around the surgical site is common, but it typically lessens as your incision heals.

Serious complications from meningioma surgery:

• Infection: Infections at the surgical site are possible and require prompt treatment with antibiotics.
• Vision changes: Meningiomas near your optic nerve or visual pathways can lead to lingering visual disturbances or changes in your vision.
• Neurological deficits: Some people may experience lingering neurological symptoms such as weakness, numbness, or coordination difficulties if the tumor was in or near areas of the brain responsible for motor function.
• Cognitive changes: Some people may experience mild cognitive impairments, such as memory difficulties or difficulty with concentration and multitasking, especially if the tumor was in areas of the brain involved in cognition.
• Brain swelling: Swelling around the brain may occur after surgery and could lead to neurological symptoms.
• Venous thromboembolism (blood clots): Some people are at risk of developing blood clots, especially in the legs, which may require blood-thinning medication. One study found that 5.7% of people undergoing microsurgical resection for intracranial meningiomas developed venous thromboembolism.
• Seizures: Some individuals may experience seizures after surgery, but medications can control and prevent them. Seizures occur in about 30% of people with meningioma. While surgical resection can lead to seizure freedom in 60%–90% of people with meningioma, approximately 12%–19% still experience seizures after surgery.
• Pneumonia: Pneumonia after surgery can occur due to various factors, such as weakened immunity after surgery, difficulty breathing and coughing, or aspiration of saliva or stomach contents into your lungs during the procedure.
• Cerebrospinal fluid leak: There can be a persistent cerebrospinal fluid (CSF) leak that requires additional treatment to repair, but this is rare.
• Brain damage: Although rare, there’s a risk of brain damage during surgery, which could cause permanent neurological deficits.

A Swedish registry-based study analyzed 2,324 people who underwent surgery for intracranial meningioma, with 14.1% being asymptomatic before surgery. Within 30 days after surgery, 14.8% developed new neurological deficits, 4.5% had new-onset seizures, and 5.2% required reoperations.

Another study from 2019 reviewed 11,414 Norwegian patients who underwent meningioma surgery and found that 14.6% experienced medical complications, including hematoma, infection, neurological decline, and death.

Being older than 65 years of age, having hypertension, and being on multiple cardiac medications were associated with higher complication rates. But the most significant risk factor was a new or worsened neurological deficit.

After surgery, you’ll need frequent monitoring in the beginning and then less frequent checkups if there are no concerns. The need for future surgery depends on factors like your tumor’s grade, how well it was removed initially, and any recurrence.

Studies indicate that up to 20% of people have meningioma recurrence within 10 years. Higher-grade meningiomas have a higher recurrence rate, ranging from 50%–94% for grade 3, while grade 1 and grade 2 meningiomas have lower rates of 7%–25% and 29%–52%, respectively.

Common elements of follow-up care typically include:

• regular clinic visits with your neurosurgeon or neuro-oncologist (cancer specialist in the brain, spine, and nervous system)
• neurological exams to assess your motor function, sensory perception, reflexes, and other neurological aspects
• brain imaging, such as MRI or CT scans, to monitor for tumor recurrence or changes in your brain
• medication management for pain management, seizure prevention, or other purposes
• rehabilitation and support in case of lingering neurological or cognitive deficits

Your outlook after meningioma surgery varies depending on your tumor grade.

People with grade 1 meningioma have the best outlook, with 5-year progression-free survival rates of 95.7% and 10-year rates of 90.4%. People with grade 2 and 3 meningiomas have lower survival rates, with those with grade 3 having the lowest (46.7% at 5 years).

Complete surgical resection (successful removal of the entire meningioma) and radiation treatment after surgery can improve survival rates, especially in those with grades 1 and 2.

Life after meningioma surgery varies from person to person. Many people experience relief from symptoms and improved quality of life after a successful surgery. However, some may have lingering complications, such as headaches, vision changes, or cognitive issues.

Regular follow-up visits are essential to monitor for any potential complications or tumor recurrence and maximize your chances of continued improvement.