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Most of the experts use radical surgery or radiation therapy to remove meningiomas.\n\t</p>\n\t<p>\n\t\t<strong>Meningioma resection is divided into:</strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\t<strong>total</strong> (whole tumor is removed);</li>\n\t\t<li>\n\t\t<strong>subtotal or partial </strong>(only a part of tumor is removed).</li>\n\t</ul>\n</div>\n\n\n\n<h2>Main options of meningioma treatment</h2>\n<i class=\"fa fa-angle-down\"></i>\n\n<div class=\"accordion-item-text\">\n\t<p style=\"text-align:justify;\">\n\t\tThe type of therapy depends on the size of the tumor, its location, the age of a patient and the presence of pathologies.\n\t</p>\n\t<p>\n\t\t<strong>There are 2 main methods of meningioma treatment:</strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\t<strong><a></a>Stereotactic radiosurgery</strong> used for difficult access to the tumor and close connection of meningioma with vessels, nerve trunks, sinuses of the brain;</li>\n\t\t<li>\n\t\t<strong>Surgical removal </strong>used in cases of the big size of meningioma (more than 3.5cm in diameter).</li>\n\t</ul>\n\t<h3>\n\t<br />\n\t<strong>Stereotactic Radiosurgery</strong></h3>\n\t<p style=\"text-align:justify;\">\n\t\tRadiosurgery is a medical procedure used for destroying of tumors or suspending their functioning by means of a single irradiation with a high dose of ionizing radiation.\n\t</p>\n\t<p>\n\t\tRadiosurgery has <strong>two main advantages</strong>:\n\t</p>\n\t<ol>\n\t\t<li>\n\t\tIrradiation <strong>affects the meningioma from different directions</strong> (tumor receives the maximum possible dose of radiation)</li>\n\t\t<li>\n\t\tRadiosurgery is <strong>non-invasive</strong> (treatment of a tumor does not require breaking the integrity of the head tissue and opening the cranium).</li>\n\t</ol>\n\t<p><br />\n\t</p>\n\t<p style=\"text-align:justify;\">\n\t\t<a></a>The contraindication for radiosurgery is the inability to operate brain tumors over 3.5 cm in diameter.<strong> </strong><span>The effectiveness of stereotactic radiosurgery is very high: about</span><strong> 95%</strong><span> of meningiomas stop their growth after a single procedure or a small course of treatment.</span>\n\t</p>\n\t<p>\n\t\tThe main <strong>radiotherapeutic / radiosurgical units</strong> are:\n\t</p>\n\t<ul>\n\t\t<li>\n\t\tGammaKnife;</li>\n\t\t<li>\n\t\tCyberKnife;</li>\n\t\t<li>\n\t\tTrueBeam.</li>\n\t</ul>\n\t<p>\n\t\t<br />\n\t\t<strong><a></a>Advantages and disadvantages of meningioma removal with the help of the GammaKnife </strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\tdesigned for <strong>non-invasive brain surgery</strong> (without the use of a scalpel);</li>\n\t\t<li>\n\t\thas a frame based system for immobilization with radiation sources, which can causeside such effects of gamma knife surgery for meningioma as headache, nausea and a risk of infection;</li>\n\t\t<li>\n\t\tone image of magnetic resonance imaging is used, in contrast to systems that do not use a frame for attaching the head and require constant imaging with CT during <a></a>treatment, making an additional contribution to excess radiation doses;</li>\n\t\t<li>\n\t\tsmall sizes of collimators protect the body tissues from the effects of radiation and excludes the possibility of treatment of metastases and tumors over 3 cm.</li>\n\t</ul>\n\t<p>\n\t\t<br />\n\t\t<strong><a></a>Features of meningioma resection with CyberKnife</strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\t<strong>universal method</strong> not only for treating the brain, but also for removing the tumor and metastasis throughout the body;</li>\n\t\t<li>\n\t\tmega-voltage X-ray radiation from the CyberKnife is four times more powerful than the energy from cobalt used in the GammaKnife;</li>\n\t\t<li>\n\t\tCyberKnife is a flexible, frameless system that allows a patient to conduct treatment in one or more sessions. This allows oncologists to choose the safest and most effective course of treatment;</li>\n\t\t<li>\n\t\tdoes not require a frame screwing into the skull for immobilization, which helps to avoid headache, nausea and the risk of infection.</li>\n\t</ul>\n\t<p><br />\n\t</p>\n\t<p>\n\t\t<strong>Peculiarities of stereotactic radiosurgery using the TrueBeam system</strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\t<a></a>Focused radiation beams of the system destroy tumor cells without affecting the surrounding healthy tissues;</li>\n\t\t<li>\n\t\tuse of a metal frame that is bolted to the skull bones of a patient <strong>is unnecessary</strong>;</li>\n\t\t<li>\n\t\topportunity of fractional irradiation (treatment is divided into 2-5 small sessions, which makes possible to safely treat large meningiomas located near important structures, for example, the optic nerve);</li>\n\t\t<li>\n\t\tTrueBeam system is equipped with modern medical imaging devices that allow a radiologist to monitor the tumor behavior in real time;</li>\n\t\t<li>\n\t\tDuring visualization of pathological formations, the technology of cone-beam computed tomography (CT) is used. This method of visualization makes possible to <strong>reduce the radiation load on the patient's body by 25%.</strong></li>\n\t</ul>\n\t<h3 style=\"text-align:center;\">\n\t<strong>Surgical treatment of meningiom</strong></h3>\n\t<p>\n\t\tThere are <strong>2 indications for surgical removal of meningioma</strong>:\n\t</p>\n\t<p><a href=\"//bookimed.com/clinics/procedure=removal-of-meningioma/\"><img src=\"/images/editor/5991586246464.jpg\" alt=\"Endoscopic resection of meningioma\" style=\"float:right;margin:0px 0px 10px 10px;\" /></a>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\tIf the tumor is in the area of the brain that is available for surgery</li>\n\t\t<li>\n\t\tIf the tumor over 3.5 cm in diameter.</li>\n\t</ul>\n\t<p><br />\n\t</p>\n\t<p style=\"text-align:justify;\">\n\t\t<strong>Endoscopic intervention</strong> is the minimally invasive method of meningioma removal, when the tumor is removed without opening the skull with endoscopic instruments. Removal of meningioma through transnasal access is most often used. The method is the most effective in combination with intraoperative MRI and nerve navigation systems.\n\t</p>\n\t<p style=\"text-align:justify;\">\n\t\t<strong><a></a>Craniotomy</strong> or <strong>trepanation of the skull</strong> is carried out only if the tumor is located close to the surface. This method provides good visibility of the operating field and allows the removal of large tumors.\n\t</p>\n</div>\n\n\n\n<h2>Preparing for the operation</h2>\n<i class=\"fa fa-angle-down\"></i>\n\n<div class=\"accordion-item-text\">\n\t<p style=\"text-align:justify;\">\n\t\tFor the accurate determination of the type of meningioma and for prescribing the fastest and most effective treatment, a patient should go through the following procedures:\n\t</p>\n\t<ul>\n\t\t<li>\n\t\t<a></a>Blood test;</li>\n\t\t<li>\n\t\tElectroencephalogram;</li>\n\t\t<li>\n\t\tAngiography;</li>\n\t\t<li>\n\t\tMRI - magnetic resonance imaging;</li>\n\t\t<li>\n\t\tMRS - magnetic resonance spectroscopy;</li>\n\t\t<li>\n\t\tCT - computed tomography;</li>\n\t\t<li>\n\t\tbiopsy.</li>\n\t</ul>\n</div>\n\n\n\n<h2>Rehabilitation after removal of meningioma</h2>\n<i class=\"fa fa-angle-down\"></i>\n\n<div class=\"accordion-item-text\">\n\t<p style=\"text-align:justify;\">\n\t\tThe rehabilitation period can range from few weeks to a year. It depends on the method of treatment and the type of operation. The physical and psychological condition of a patient <a></a>before surgery also affects the postoperative period. The recovery will occur quickly if a patient follows a doctor's prescribed rehabilitation program and takes the necessary medicines.\n\t</p>\n</div>\n\n\n\n<h2>Consequences after meningioma removal</h2>\n<i class=\"fa fa-angle-down\"></i>\n\n<div class=\"accordion-item-text\">\n\t<p style=\"text-align:justify;\">\n\t\tConsequences after the removal of meningioma depend on tumor localization, prevalence of pathological process and histologic type. Young people have none of consequences after meningioma resection in contrast to elderly patients, who face negative effects much more often.\n\t</p>\n\t<p>\n\t\t<strong>Consequences after resection of meningioma can be various:</strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\tloss of sight;</li>\n\t\t<li>\n\t\thearing loss;</li>\n\t\t<li>\n\t\tsensitivity depression;</li>\n\t\t<li>\n\t\tparalysis of extremities;</li>\n\t\t<li>\n\t\t<a></a>lacks of coordination;</li>\n\t\t<li>\n\t\trecurrence.</li>\n\t</ul>\n</div>\n\n\n   \n       \t\n\n<h2>Recurrence of meningioma after removal</h2>\n\n       <i class=\"fa fa-angle-down\"></i>\n   \n   <div class=\"accordion-item-text\">\n  \t \n\n\t<p>\n\t\t<strong>Meningioma recurrence rate after the operation:<img alt=\"\" src=\"/ckfiles/images/meningioma-recur.jpg\" title=\"Recurrence of meningioma\" style=\"width:300px;height:206px;float:right;\" /></strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\t<strong>3%</strong> for benign tumors;</li>\n\t\t<li>\n\t\t<strong>38%</strong> for atypical tumors;</li>\n\t\t<li>\n\t\t<strong>78%</strong> for malignant tumors.</li>\n\t</ul>\n\t<p>\n\t\t<br />\n\t\t<strong>Also possibility of meningioma recurrence depends on location of a tumor. </strong>\n\t</p>\n\t<ul>\n\t\t<li>\n\t\tat the cranial vault is <strong>3%</strong>;</li>\n\t\t<li>\n\t\tin the region of the Turkish saddle is <strong>19%</strong>;</li>\n\t\t<li>\n\t\tin the region of the body of the sphenoid bone <strong>34%</strong> within five years;</li>\n\t\t<li>\n\t\tin the cavernous sinus is <strong>60-100%</strong>.</li>\n\t</ul>\n\n   </div>"},"guide_mc":{"text":"<p>Day 1 - Arrival</p>\n<ul>\n<li>Pickup from airport and transfer to hotel.</li>\n</ul>\n\n<p>Day 2 - Pre-operation</p>\n<ul>\n<li>Transfer to clinic.</li>\n<li>Consultation with neurosurgeon and anesthesiologist.</li>\n<li>Pre-operative tests including blood tests and biopsy.</li>\n<li>Preparation for surgery.</li>\n</ul>\n\n<p>Day 3 - Surgery</p>\n<ul>\n<li>Transfer to operating room.</li>\n<li>Administration of general anesthesia.</li>\n<li>Removal of meningioma surgery (duration varies from 2-6 hours).</li>\n<li>Post-surgery monitoring in recovery room.</li>\n<li>Transfer back to hospital room.</li>\n</ul>\n\n<p>Day 4-6 - Post-operation</p>\n<ul>\n<li>Continued hospital stay for monitoring and recovery.</li>\n<li>Post-operative care including pain management and wound care.</li>\n</ul>\n\n<p>Week 1-2 - Rehabilitation</p>\n<ul>\n<li>Transfer back to hotel for continued recovery.</li>\n<li>Follow-up appointments with neurosurgeon.</li>\n<li>Physical therapy if necessary.</li>\n</ul>\n\n<p>Week 3-6 - Continued Rehabilitation</p>\n<ul>\n<li>Gradual return to light activities.</li>\n<li>Continued follow-up appointments and physical therapy.</li>\n</ul>\n\n<p>Week 7 onwards</p>\n<ul>\n<li>Return to work and normal activities upon doctor\"s advice.</li>\n<li>Final results can be seen several months post-operation.</li>\n</ul>\n\n<p><i>Please note that each patient\"s recovery is unique and timelines may vary.</i></p>"}}},"relations":{"countries":[{"name":"Azerbejdżan","alias":"azerbaijan","iso_code":"AZ"},{"name":"Chiny","alias":"china","iso_code":"CN"},{"name":"Egipt","alias":"egypt","iso_code":"EG"},{"name":"Grecja","alias":"greece","iso_code":"GR"},{"name":"Hiszpania","alias":"spain","iso_code":"ES"},{"name":"Indie","alias":"india","iso_code":"IN"},{"name":"Izrael","alias":"israel","iso_code":"IL"},{"name":"Meksyk","alias":"mexico","iso_code":"MX"},{"name":"Niemcy","alias":"germany","iso_code":"DE"},{"name":"Republika Korei","alias":"republic-of-korea","iso_code":"KR"},{"name":"Rumunia","alias":"romania","iso_code":"RO"},{"name":"Szwajcaria","alias":"switzerland","iso_code":"CH"},{"name":"Tajlandia","alias":"thailand","iso_code":"TH"},{"name":"Turcja","alias":"turkey","iso_code":"TR"},{"name":"Włochy","alias":"italy","iso_code":"IT"},{"name":"ZEA","alias":"united-arab-emirates","iso_code":"AE"}],"cities":[{"name":"Baku","alias":"baku"}],"operations":[{"name":"Usunięcie guza mózgu","alias":"removal-of-the-brain-tumor"},{"name":"Prostatektomia","alias":"prostatectomy"},{"name":"Usunięcie guza rdzenia kręgowego","alias":"removal-of-spinal-cord-tumor"},{"name":"Radioterapia","alias":"radiotherapy"},{"name":"Kraniotomia","alias":"craniotomy"},{"name":"Transnazalne usunięcie guza","alias":"transnasal-resection-of-tumor"},{"name":"Trachelektomia","alias":"trachelectomy-cervicectomy"},{"name":"Operacje stereotaktyczne","alias":"stereotaxic-surgeries"},{"name":"Usunięcie oponiaka","alias":"removal-of-meningioma"},{"name":"Usunięcie guza przysadki mózgowej","alias":"pituitary-tumor-surgery"},{"name":"Chirurgia guza mózgu","alias":"brain-tumor-surgery"},{"name":"Mastektomia","alias":"mastectomy"},{"name":"Laparoskopowe usunięcie nerki","alias":"laparoscopic-nephrectomy"},{"name":"Chemioterapia","alias":"chemotherapy"},{"name":"Resekcja tarczycy","alias":"thyroid-resection"},{"name":"Resekcja w przypadku raka wątroby","alias":"removal-of-liver-cancer"},{"name":"Operacja raka jelita grubego","alias":"removal-of-colon-cancer"},{"name":"Zogniskowana ablacja ultradźwiękowa (HIFU)","alias":"high-intensity-focused-ultrasound-ablation-hifu"},{"name":"Terapia protonowa","alias":"proton-beam-therapy"},{"name":"Usunięcie czerniaka","alias":"melanoma-surgery"},{"name":"Usunięcie nerki","alias":"nephrectomy"},{"name":"Operacja raka żołądka","alias":"gastrectomy"},{"name":"Ezofagektomia","alias":"esophagectomy"},{"name":"Resekcja jelita cienkiego","alias":"small-intestine-surgery"},{"name":"Hormonterapia","alias":"hormonal-therapy"},{"name":"TURP (przezcewkowa resekcja prostaty)","alias":"transurethral-resection-of-the-prostate-turp"},{"name":"Operacja raka piersi","alias":"operation-on-breast-cancer"},{"name":"Histerektomia (usunięcie macicy)","alias":"hysterectomy"},{"name":"Immunoterapia","alias":"immunotherapy"},{"name":"Terapia celowana","alias":"targeted-therapy"},{"name":"Lumpektronomia","alias":"lumpectomy"},{"name":"Subtotalna tyreoidektomia","alias":"subtotal-thyroidectomy"},{"name":"Hipec (Hipertermiczna Chemioterapia Dootrzewnowa)","alias":"hyperthermic-intraperitoneal-chemotherapy"},{"name":"Procedura Whipple’a","alias":"whipple-surgery"},{"name":"Lymphadenektomia","alias":"lymphadenectomy"},{"name":"Przezcewkowa resekcja guza pęcherza moczowego","alias":"transurethral-resection-of-the-bladder"},{"name":"Terapia miejscowa czerniaka","alias":"topical-therapy-of-melanoma"},{"name":"Szerokie wycięcie czerniaka","alias":"wide-excision-of-melanoma"},{"name":"Chirurgia laserowa przy raku szyjki macicy","alias":"laser-surgery"},{"name":"Lobektomia (usunięcie płata płuca)","alias":"lobectomy"},{"name":"Operacja raka płuc","alias":"lung-cancer-surgery"},{"name":"Usunięcie pęcherza moczowego","alias":"rezekcia-mocevogo-puzyra"},{"name":"Krioterapia","alias":"cryotherapy"},{"name":"Resekcja kości","alias":"resection-of-the-bone"},{"name":"TUIP (transuretralne nacięcie) prostaty","alias":"transurethral-incision-of-the-prostate-tuip"},{"name":"Usunięcie polipów przewodu pokarmowego","alias":"polypectomy"},{"name":"Kolektomia (resekcja jelita grubego)","alias":"colectomy-large-bowel-resection"},{"name":"Resekcja wątroby","alias":"liver-resection"},{"name":"Resekcja odbytnicy","alias":"rectal-resection"},{"name":"Immunoterapia Keytruda (Pembrolizumab)","alias":"keytruda"},{"name":"Usunięcie glejaka","alias":"resection-of-glioma"},{"name":"Usunięcie glejaka wielopostaciowego","alias":"resection-of-glioblastoma"},{"name":"Tyreoidektomia","alias":"thyroidectomy"},{"name":"Chemioterapia przy raku wątroby","alias":"chemotherapy-for-liver-cancer"},{"name":"Chemoembolizacja wątroby","alias":"chemoembolization-of-the-liver"},{"name":"Chemioterapia raka krtani","alias":"chemotherapy-for-larynx-cancer"},{"name":"Operacja raka krtani","alias":"throat-cancer-operation"},{"name":"Operacja raka języka","alias":"tongue-cancer-surgery"},{"name":"Laparoskopowa prostatektomia","alias":"laparoscopic-prostatectomy"},{"name":"Resekcja segmentowa płuca","alias":"lung-segmentectomy"},{"name":"Chemioterapia raka płuc","alias":"chemotherapy-for-lung-cancer"},{"name":"Chemioterapia raka prostaty","alias":"chemotherapy-for-prostate-cancer"},{"name":"Immunoterapia raka prostaty","alias":"immunotherapy-for-prostate-cancer"},{"name":"Terapia hormonalna raka prostaty","alias":"hormone-therapy-for-prostate-cancer"},{"name":"Chemioterapia raka macicy","alias":"chemotherapy-for-uterine-cancer"},{"name":"Chemioterapia w raku piersi","alias":"chemotherapy-for-breast-cancer"},{"name":"Immunoterapia raka płuc","alias":"immunotherapy-for-lung-cancer"},{"name":"Immunoterapia raka piersi","alias":"immunotherapy-for-breast-cancer"},{"name":"Immunoterapia w raku nerki","alias":"immunotherapy-for-kidney-cancer"},{"name":"Gastrektomia","alias":"gastroectomy"},{"name":"Operacja raka trzustki","alias":"pancreatic-cancer-surgery"},{"name":"Resekcja jelita grubego","alias":"resection-of-large-intestine"},{"name":"Chemioterapia przy raku przełyku","alias":"chemotherapy-for-esophageal-carcinoma"},{"name":"Chemioterapia w przypadku chłoniaka","alias":"lymphoma-chemotherapy"},{"name":"Terapia protonowa w raku prostaty","alias":"proton-therapy-for-prostate-cancer"},{"name":"Laparoskopowa histerektomia","alias":"laparoscopic-hysterectomy"},{"name":"Częściowa glossektomia (resekcja języka)","alias":"partial-glossectomy"},{"name":"Skoncentrowana 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demands."},"complication_rate_pct":{"min":10,"max":30,"unit":"percent","qualifier":"Any surgical or medical complication within 90 days; serious permanent deficits roughly 5-10%, higher for skull base tumors."},"contraindications":["Unacceptable anesthetic or medical risk from severe comorbidity (relative)","Uncorrected coagulopathy or unsafe anticoagulation interruption (relative, correctable)","Small asymptomatic meningioma suited to observation or radiosurgery (relative)","Prohibitive neurological risk, e.g. extensive cavernous sinus involvement (relative)","Active uncontrolled systemic infection (relative)"],"days_in_clinic":{"min":3,"max":7,"unit":"nights","qualifier":"Uncomplicated craniotomy, including short ICU or high-dependency monitoring; longer if complications or deficits occur."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Light walking early; strenuous or contact exercise only after surgeon clearance and bone flap healing."},"final_result_months":{"min":3,"max":12,"unit":"months","qualifier":"Time for neurological recovery and postoperative MRI assessment of the extent of resection; varies by location and grade."},"fly_home_after_days":{"min":10,"max":14,"unit":"days","qualifier":"After surgeon clearance, wound check and imaging; later if seizures, CSF leak, neurological deficits or complications occur."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":14,"unit":"days","qualifier":"Wound check and suture or staple removal, counted from 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tumor resection","Anesthesia-related risks"],"pain":"Moderate headache and scalp/incision pain for the first days to weeks, usually controlled with analgesics; jaw pain may occur with temporal approaches.","preparation":["MRI with contrast, sometimes CT or angiography","Anesthesia and medical assessment, blood tests","Medication review, including blood thinners and anti-seizure drugs","Fasting before general anesthesia","Discussion of risks, goals and consent","Steroids may be prescribed for edema"],"recovery_timeline":[{"phase":"Hospital stay (days 0-7)","description":"Monitoring in ICU or high-dependency unit, neurological checks, early mobilization, postoperative imaging.","restrictions":["No driving","Assisted mobility initially"]},{"phase":"Early home recovery (weeks 1-6)","description":"Fatigue, headache and wound healing; gradual increase in walking and activity.","restrictions":["No heavy lifting or straining","No driving until cleared, especially if seizures","Keep the wound dry and clean"]},{"phase":"Return to activities (weeks 6-12)","description":"Return to work and normal activities for most patients after uncomplicated surgery; gradual return of exercise.","restrictions":["No contact sports until cleared by surgeon"]},{"phase":"Long-term (3-12 months)","description":"Continued neurological recovery and surveillance MRI.","restrictions":[]}],"rehabilitation_days":{"min":30,"max":90,"unit":"days","qualifier":"Ordinary functional recovery after uncomplicated craniotomy; formal neurorehabilitation may extend this when deficits are present."},"result_longevity":"Complete resection of low-grade tumors often gives long-term control, but recurrence is possible and depends on the extent of resection and WHO grade; long-term MRI surveillance is needed.","revision_rate_pct":{"min":3,"max":10,"unit":"percent","qualifier":"Reoperation within 30-90 days for hematoma, CSF leak, infection or wound problems; excludes later recurrence surgery."},"scars":"A scalp 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or growing meningiomas, particularly convexity, falx and accessible skull base tumors.","recovery":"Hospital stay of several days; return to normal activities within about 1-3 months."},{"name":"Endoscopic endonasal or keyhole approach","suits_whom":"Selected small or midline skull base meningiomas, such as tuberculum sellae, in specialized centers.","recovery":"Often a shorter stay, though skull base reconstruction and CSF leak risks need attention."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":3,"max":6,"unit":"hours","qualifier":"Operating time for a typical craniotomy for a single accessible meningioma; complex skull base tumors can take longer."},"initial_assessment_documents":["Brain MRI with and without contrast (DICOM)","Brain CT scan (if available)","Radiology report of the tumor","Neurological symptoms summary and seizure history","List of blood thinners","Previous biopsy or surgery report (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 10-14 days including hospital stay and wound check. MRI follow-ups are usually done at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the medical team’s qualifications","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Ask questions about the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that the clinic or hospital has satisfactory facilities and standards","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Red, inflamed, painful surgical wound","urgency":"contact_clinic","general":false,"source":{"url":"https://www.plymouthhospitals.nhs.uk/display-pil/pil-planned-surgery-for-anterior-front-or-middle-meningioma-6996/","host":"plymouthhospitals.nhs.uk","quote":"If your wound becomes, red, inflamed, painful, and/or you have a temperature please contact the ward as soon as possible for a review, antibiotics or a neurosurgical consultation might be required.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"New weakness or paralysis","urgency":"emergency","general":false,"source":{"url":"https://www.cuh.nhs.uk/patient-information/skull-base-meningioma/","host":"cuh.nhs.uk","quote":"This can include weakness or paralysis, difficulty in breathing or impaired swallowing.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"Difficulty 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