Some general guidelines for the treatment of these tumors can be outlined. For patients with mild or nonprogressive symptoms it may be appropriate to follow the patient with periodic scans and examination to determine whether the lesion is growing and to see whether the symptoms are significantly interfering with the patient's life. Radiation therapy is used in older patients with small and medium-size tumors with worsening symptoms and for regrowth after subtotal or radical subtotal removal. The operative approach is similar to that used for tuberculum sella meningioma but with a more temporal exposure. It may be necessary to open the medial aspect of the Sylvian fissure to define the middle cerebral artery.
Some soft tumors can be more easily removed than very fin-n hard tumors.
Identification of the distal branches of the middle cerebral artery and following them to the tumor capsule to determine whether it is feasible to dissect them. In some situations arachnoid planes help in separating the tumor from around the encased arteries. Identification of the optic chiasm and following the optic nerve into the tumor. As the tumor grows the arachnoid membrane remains intact, making microsurgical dissection from the internal carotid artery and optic nerve possible. There were 13 women and four men ranging in age from 28 to 79 years, with two over 70 years of age.