Background and purpose: As the postoperative recurrence of meningioma can have devastating effects, it is important to identify factors that can be used to predict this type of tumor recurrence. Material and methods: We have performed a retrospective study involving 138 patients who were surgically treated for intracranial meningioma between 2005 and 2010. The patient population consisted of 80 females and 58 males, with an age range of 23 to 77 years old (mean age = 52 years). We measured associations between meningioma recurrence and clinical features (age, sex, extent of resection, histological type), or radiological features (tumor size, location, shape, calcification, bone changes, brain tumor interface, tumor necrosis, and MRI enhancement). Results: We found statistically higher levels of postoperative meningioma recurrence in patients with high Simpson grade resections, high histological types, tumor diameters > 5 cm, tumors located in the base of the skull or the parasagittal sinus, tumors with unclear border, irregular enhancements on MRI, edema around the tumor, bleeding and necrosis within the tumor, and irregularly shaped tumors (e.g., lobulated or mushroom-shaped). In addition, calcification, age, sex, bone change, and dural tail sign provided no predictive value. C onclusions: We have shown that histological type, degree of resection, bleeding, necrosis, edema, irregular enhancement, location, shape, size, and margin serve as strong predictors for the postoperative recurrence of meningioma tumors.

Chronic subdural hematoma (CSDH) formation mechanism is very complex, and has not entirely understood. It represents a frequent type of intracranial hemorrhage, and is very common disease in Neurosurgery practice, especially in older patients. Various surgical treatments have been proposed for the treatment of CSDH. The rate of recurrence in CSDH after surgery ranges from 5% to 30%, repeated surgery must be considered. But in some cases subdural collections are still persistent. Endovascular embolization of the middle meningeal artery (MMA) is an option for treatment of refractory CSDH. We review all cases that were treated with embolization to assess the effect of this intervention. Our review revealed 6 papers with a total enrollment of 14 patients were treated with MMA embolization for refractory chronic subdural hematoma without any postoperative complication or recurrence. In this study we suggest MMA embolization as an alternative for treatment of non-curable CSDH, especially for old people with systematic diseases, who cannot tolerate repeat surgery.