In preparation for the procedure, the patient is anesthetized and all or a portion of the scalp may be shaved. The patient’s head is secured to prevent movement.

The surgeon then creates a long, arched incision in the scalp overlying the tumor. The soft tissue is folded back to expose the skull. The surgeon drills one or more small holes into the skull and then saws between the holes to free a section of bone. This “craniotomy” bone flap is removed and stored. The surgeon now has direct access to the brain, which is covered by the dura. Removing the Tumor In most cases, the meningioma is attached to the dura. Soft, flexible retractors may be used to hold healthy brain tissue aside to give the surgeon room to work. The surgeon then removes as much of the meningioma as can safely be removed. In some cases, this will be the entire tumor, but it may be necessary to leave a small amount of tumor and treat this portion with other methods such as focused radiation. The surrounding dura is usually removed and the area is patched with graft material.