Concierge neuro-oncology · London
Craniotomy for meningioma, by a skull-base neurosurgeon.
A clinically reviewed guide to surgery for meningioma — WHO grade, Simpson resection, skull-base considerations, and when stereotactic radiosurgery or watch-and-wait is the better answer.
Why patients choose us
- 01
A skull-base neurosurgeon, not a generalist
Meningiomas at the sphenoid wing, olfactory groove or foramen magnum need a neurosurgeon who does skull-base work weekly — not one who does it occasionally.
- 02
Neuro-oncology MDT before you agree
The plan is set by a multidisciplinary meeting — neurosurgery, radiation oncology, neuroradiology — so surgery, stereotactic radiosurgery and watch-and-wait are weighed honestly.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What meningioma surgery and radiosurgery cost privately in London.
Indicative ranges across our partner clinics. Send the imaging and we come back with firm figures across the options that apply.
In short
A convexity meningioma craniotomy in our network: £18,000–£28,000, typical stay 4–7 days.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Neurosurgical consultation | £300–£600 | 45–60 min | Same visit |
| Volumetric MRI brain with contrast | £600–£1,200 | 45 min | 24–72 hrs |
| Craniotomy for convexity meningioma | £18,000–£28,000 | 3–5 hrs | 4–7 days stay |
| Craniotomy for skull-base meningioma | £28,000–£45,000 | 5–8 hrs | 5–10 days stay |
| Stereotactic radiosurgery (single fraction) | £8,000–£16,000 | Half-day | Outpatient |
| Fractionated external beam radiotherapy | £10,000–£20,000 | 15–30 visits | 3–6 weeks |
Prices vary by tumour location and grade, by the neurosurgeon and clinic, by intraoperative adjuncts (neuronavigation, monitoring, awake mapping) and by length of hospital stay. We come back with firm figures once the imaging is reviewed.
The problem
The right operator, the right operation — and sometimes, no operation at all.
Meningioma decisions are quietly complex — grade, size, location, symptoms and age all interact. We make sure the plan comes from a neuro-oncology MDT, not a single opinion.
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Is surgery even needed?
For a small, asymptomatic incidentaloma — especially in older patients — watch-and-wait is often the right answer. We say so before you agree to surgery.
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Convexity or skull-base?
Skull-base tumours belong in the hands of a subspecialist neurosurgeon who does that anatomy routinely — not a generalist.
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Surgery or radiosurgery?
Small, residual or recurrent tumours are often better treated with stereotactic radiosurgery than repeat craniotomy. That trade-off should be weighed openly.
The journey
From imaging to follow-up MRI — what happens, in order.
One point of contact from first scan to long-term follow-up — including radiotherapy pathways if adjuvant treatment is needed.
Phase 1 · Imaging and decision
Concierge, off-stage for you
Phase 2 · Surgery or SRS
Days in a neurosurgical unit
Phase 3 · Follow-up
Histology, radiotherapy, MRI
- 01
Before
You send the imaging
A short, confidential form and the MRI. We review whether this is a symptomatic meningioma, an incidentaloma, or something that needs a different plan altogether.
- 02
Before
MDT and a recommendation
Within a few working days: whether to watch, operate or offer stereotactic radiosurgery — and which neurosurgeon fits the location and grade.
- 03
Before
Consent, imaging and workup
Volumetric MRI, angiography if the tumour is near a sinus, blood work, and an anaesthetic review. Anticonvulsants and steroids are discussed.
- 04
On the day
Admission and craniotomy
A named neurosurgeon in a full neurosurgical theatre. Neuronavigation, intra-operative monitoring, and — where relevant — awake mapping for eloquent locations.
- 05
On the day
Resection with the Simpson aim
The tumour, its dural attachment and any involved bone are removed where safely possible — a Simpson grade I resection carries the lowest recurrence risk.
- 06
After
Neuro-ICU then step-down
A short neuro-ICU stay for observation, then the ward. Typical hospital stay is four to seven days for a convexity meningioma; longer for skull-base cases.
- 07
After
Histology, MDT and follow-up
WHO grade is confirmed on histology (I, II or III). If grade II or III, adjuvant radiotherapy is discussed. Follow-up MRI is scheduled at three months, then annually.
Typical end-to-end: 3–6 weeks from imaging to surgery. Return to normal activities: 6–12 weeks.
When it helps
When craniotomy for meningioma is the right step.
The situations we see most — plus the red flag that means an emergency rather than an outpatient appointment.
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Symptomatic meningioma
Headache, focal weakness, seizures, visual field loss or cognitive change from tumour mass effect — the commonest reason to operate.
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Growing incidentaloma
A small meningioma found by chance that has grown on serial MRI — intervention is discussed rather than continued watching.
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Convexity or parasagittal tumour
Superficial tumours over the cerebral convexity or straddling the sagittal sinus — often suitable for a Simpson grade I resection.
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Skull-base meningioma
Sphenoid wing, olfactory groove, tuberculum sellae, cavernous sinus, cerebellopontine angle or foramen magnum — technically demanding, cranial-nerve territory.
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Atypical or anaplastic (WHO II / III)
Higher-grade meningiomas need maximal safe resection and, usually, adjuvant radiotherapy — the surgical target is aggressive.
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Watch-and-wait
Small, asymptomatic tumours in older or frail patients are often best served by serial imaging — not every meningioma needs surgery.
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Stereotactic radiosurgery
Small residual, recurrent or surgically inaccessible tumours are often treated with single-fraction SRS rather than open surgery.
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Red flag: rapid deterioration
Sudden severe headache, new focal deficit, reduced consciousness or a first-ever seizure is a same-day emergency — A&E, not a clinic booking.
Treatment options
Craniotomy is not the only option.
What each pathway actually involves — from watchful waiting through Simpson grade I resection to stereotactic radiosurgery and external beam radiotherapy.
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Watch-and-wait
Small, asymptomatic incidentalomas — especially in older patients — are monitored with serial MRI. Only tumours that grow or cause symptoms are treated.
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Simpson grade I resection
The tumour, its dural attachment and any involved bone are all removed. Historically the lowest recurrence risk — the surgical ideal where the location allows.
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Simpson grade II–III resection
Tumour removed with coagulation (II) or without treatment of the dural attachment (III) — used where sinuses or cranial nerves prevent a grade I.
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Subtotal (Simpson IV) resection
Partial resection of a skull-base or sinus-invading tumour — a deliberate compromise to protect cranial nerves, arteries or venous sinuses.
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Stereotactic radiosurgery (SRS)
A single high-dose treatment for small tumours (<3 cm), residual disease after subtotal resection, or recurrence — no craniotomy required.
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Fractionated external beam RT
Standard adjuvant treatment for atypical (WHO II) and anaplastic (WHO III) meningiomas, and for larger or eloquent-location tumours unsuitable for SRS.
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Embolisation before surgery
For vascular tumours — especially sphenoid wing or convexity — pre-operative endovascular embolisation reduces intra-operative blood loss.
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Consultation only
A second opinion on the MDT recommendation — whether to operate, irradiate, or continue observation — with no obligation to proceed.
Our vetted London network
A small panel of neurosurgeons, we picked them.
Consultant neurosurgeons with declared skull-base and neuro-oncology subspecialties, based across central London teaching hospitals. Introductions are made privately, once we understand the case.
Selection criteria
How we choose every neurosurgeon in our network.
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Consultant neurosurgeons with a declared skull-base or neuro-oncology subspecialty
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Every case discussed at a neuro-oncology MDT before booking
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Intraoperative neuronavigation, monitoring and — where relevant — awake mapping available
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Direct pathway to stereotactic radiosurgery and radiation oncology partners
Safety and recovery
What to expect — honestly, by tumour location.
Convexity meningioma surgery is well-tolerated. Skull-base surgery carries a real and specific set of risks — cranial nerves, venous sinuses, CSF pathways — that deserve to be spelled out before consent.
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Recurrence depends on grade and Simpson
WHO grade I with a Simpson grade I resection has the lowest recurrence risk. Atypical (II) and anaplastic (III) tumours recur more often, even after complete surgery.
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Cranial nerve injury (skull-base)
Sphenoid wing, cavernous sinus and cerebellopontine angle tumours sit against cranial nerves — vision, eye movement, facial sensation and hearing can all be affected.
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Venous sinus injury (parasagittal)
Parasagittal and falcine tumours straddle the sagittal sinus. Complete resection is not always safe — the alternative is a subtotal resection plus radiotherapy.
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CSF leak and meningitis
Skull-base approaches carry a small risk of a persistent cerebrospinal fluid leak, which can occasionally lead to meningitis and needs prompt attention.
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Seizures on eloquent locations
Convexity meningiomas near motor or language cortex can cause post-operative seizures. Anticonvulsants are often used peri-operatively.
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Hydrocephalus after skull-base surgery
Posterior fossa and foramen magnum surgery can disturb CSF flow. A small proportion of patients need a shunt or endoscopic third ventriculostomy.
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Radionecrosis after SRS
Stereotactic radiosurgery can — uncommonly — cause radiation necrosis months to years later. It is managed with steroids and, occasionally, bevacizumab.
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Hormonal factors
Meningiomas express progesterone receptors and can grow in pregnancy or with hormonal treatments. This is factored into the plan and follow-up.
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Red flags
A new focal deficit, first-ever seizure, worsening headache or reduced consciousness after surgery are not normal — call the neurosurgical team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the surgery was for a convexity or skull-base meningioma, the note the neurosurgeon sends you keeps to the same shape.
A quiet reminder
Neurosurgical language is precise — and can read alarmingly. We translate it for you.
If you would like us to talk you through the note and the post-operative MRI before your follow-up, just ask.
- 01 Header
Location, grade and Simpson resection
Where the meningioma sat, its WHO grade on histology (I benign, II atypical, III anaplastic), and the Simpson grade of resection achieved.
- 02 Technique
Approach, monitoring and adjuncts
The craniotomy approach used, whether neuronavigation and intraoperative monitoring were employed, and whether pre-operative embolisation was performed.
- 03 Findings
Cranial nerves, sinuses and residual
Notes on cranial nerve preservation, involvement of venous sinuses, whether any tumour was deliberately left behind, and immediate post-operative status.
- 04 Impression
Adjuvant plan and follow-up MRI
Read this first: whether adjuvant SRS or external beam radiotherapy is planned, and when the follow-up MRI is scheduled.
Recognised by major UK insurers
Meningioma surgery is generally covered by major UK insurers when medically indicated. Cover for stereotactic radiosurgery and adjuvant radiotherapy varies — we confirm cover before booking.
Frequently asked
Everything we get asked about meningioma surgery.
Quick answers on WHO grade, Simpson resection, skull-base risks, stereotactic radiosurgery, and when watch-and-wait is the right answer.
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What is a meningioma?
A meningioma is a tumour that arises from the arachnoid cap cells of the meninges — the layers that cover the brain and spinal cord. Most are slow-growing and benign (WHO grade I), a minority are atypical (WHO grade II) or anaplastic (WHO grade III).
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Does every meningioma need surgery?
No. Small, asymptomatic incidentalomas — particularly in older or frail patients — are often watched with serial MRI. Surgery is offered when a tumour causes symptoms, grows on scans, or is likely to cause problems given its size and location.
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What is the Simpson grade?
The Simpson grading system describes how completely a meningioma has been removed. Grade I means the tumour, its dural attachment and any involved bone are all excised — the lowest recurrence risk. Grades II–V describe progressively less complete resections.
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What does WHO grade I, II or III mean?
The WHO grade reflects how the tumour looks under the microscope. Grade I is benign and the commonest. Grade II (atypical) is more likely to recur. Grade III (anaplastic) is malignant and always needs radiotherapy after surgery.
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What is stereotactic radiosurgery (SRS)?
SRS delivers a single, high dose of precisely targeted radiation to a small tumour without opening the skull. It is used for small meningiomas, residual disease after subtotal resection, and recurrent tumours — as an alternative to further surgery.
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Do I need radiotherapy after craniotomy?
Not for a Simpson grade I resection of a WHO grade I meningioma. Atypical (WHO II) tumours are often offered adjuvant radiotherapy, especially after subtotal resection. Anaplastic (WHO III) tumours are always treated with radiotherapy after surgery.
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What are the risks of skull-base meningioma surgery?
Cranial nerve injury (vision, eye movement, facial sensation, hearing), CSF leak, meningitis, sinus injury, seizures, hydrocephalus and — for higher grades — recurrence and malignant transformation over time. Risk profile depends heavily on tumour location.
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How long is the hospital stay?
Typically four to seven days for a convexity meningioma and five to ten days for a skull-base case, including a short neuro-ICU period. Recovery to normal activities usually takes six to twelve weeks.
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Can hormones or pregnancy affect a meningioma?
Yes. Meningiomas commonly express progesterone receptors and can grow during pregnancy or with certain hormonal treatments (including some progestins). This is factored into decision-making and follow-up.
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When should I seek urgent medical help?
A first-ever seizure, sudden severe headache, new weakness, speech difficulty, visual loss or reduced consciousness — before or after surgery — is a same-day emergency. Attend A&E rather than waiting for a clinic appointment.
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In practice, in London
What craniotomy of meningioma looks like on the ground in London
For craniotomy of meningioma, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Public provision for craniotomy of meningioma is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
A typical private booking for craniotomy of meningioma in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For craniotomy of meningioma in particular, we bias towards consultants who do this every week rather than every month.
The value of going through a concierge for craniotomy of meningioma isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.
Nearby in the library