I think your PCP recognizes it is not his area of expertise and I respect him for not getting involved, although he should have owned up to not being schooled enough in the management of meningiomas rather than just say, "it's your decision." My meningioma was found when I was scanned for something else. My PCP said not to worry. We find meningiomas in older people all the time when we scan for other things like strokes, headaches. End of story. I went back a year later and made the decision to tell him I wanted a referral to a neurologist to further discuss the ramifications of the growth in my brain. First of all, I think whenever we're talking about our brain, and possible surgery, we should always get a 2nd opinion, if not a 3rd. Secondly, from what you write, it seems that the neurologist gave you very little information. You qualify your meningioma as "small." Didn't he tell you how many millimeters/centimeters? Did he tell you where it is located? Is the meningioma located near any critical structures or nerves? Is the area where it is located an easier area to operate? The answer to these questions is information you need to know to make an informed decision. I've written about my experience on this forum more than a few times as new people are diagnosed with a meningioma and find their way to this website and I remember the fear and anxiety I had. So I won't go into detail about my experience with being diagnosed a year ago with a 3 centimeter meningioma 1/16th of an inch from my optic nerve. I will offer that my neurosurgeon at UCSF specializes in meningioma surgery and also runs the radiation clinic at UCSF. He told me surgery is the best option if it can be performed safely. (As a side note, the location of my meningioma was not in an easily accessible area. Two other neuro doctors said it was not in a location that was operable and they said to have radiation.) I saw neuro-oncologist (who specializes in radiation for cancer patients whose tumors are not amenable to surgery) and I didn't like the possible side effects he listed from radiation. Based on my own experience, if you're healthy and the meningioma is in a relatively easy location to access, I would at least keep an open mind and consider a craniotomy. I will qualify that by saying, but only if you go to a hospital with top-notch neurosurgeons. I spent 2 nights in the hospital and was up and walking around the house as usual as soon as I got home. (Though I will admit one of my cranial nerves was traumatized by the surgery and for 3 months I had double vision.) The key to all of this, making an informed decision, is dependent on find a neurosurgeon who answers questions you maybe even didn't know you had yet, and who you trust.