What Happens: Prior to Surgery

  1. For those with significant symptoms caused by “peritumoral edema”, i.e. swelling around the meningioma, it is better to reduce/minimize this swelling prior to surgery. You will be treated with approximately a 1-3 week course of an oral steroid agent called, “Dexamethasone (or Decadron)”.  The length of steroid course is determined by the severity of edema and symptoms.
  1. Oral steroids may cause stomach irritation (“gastritis”), and to prevent this from occurring, you will be started on either Pepcid or Zantac along with your Decadron.
  1. Depending on the tumor size, location and symptoms, you will also be started on a seizure medicine (“anti-epileptic”) for seizure prevention, usually Keppra or Dilantin, which will be discontinued about 4-6 weeks following surgery provided that you remain seizure-free after surgery.
  1. If your symptoms are not debilitating, you will work or carry on with your normal daily activities until the day of surgery.
  1. In the few weeks leading up to your surgery, you will obtain the following preoperative evaluations: Chest X-ray, EKG, blood tests (Metabolic panel, CBC, PT/INR, PTT)
  1. In preparation for surgery, you will be instructed to discontinue any blood thinners (such as Aspirin, Advil, Coumadin, Plavix, etc.) from 3 to 7 days prior to surgery. If this instruction is not followed, your surgery will be canceled.
  1. You will be instructed to not eat or drink anything after midnight prior to the morning of surgery. On the day of surgery, you may take important medications with minimal sips of water (such as medications for hypertension).

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