Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Abstract

MeningioMas constitute approximately 15%-20% of all intracranial neoplasms and are often associated with favorable clinical prognosis because of their benign histology. Because of the high survival rates associated with meningiomas, patients with meningiomas can expect increased functional capacity compared with patients harboring other brain tumors. Parameters such as the rate of survival, tumor recurrence, and progression, 8 as well as the quality of life 3,17 of these patients, have traditionally been used to assess outcomes after intracranial meningioma surgery. According to recommendations from current outcomes research programs, neuropsychological-cognitive parameters also need to be incorporated to comprehensively evaluate surgical outcomes.Although meningiomas are extraaxial tumors, cognitive decline may arise due to perilesional edema and mass obJective Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. methods Patients with skull base (anterior and middle fossa) and convexity (anterior and posterior) meningiomas (n = 54) underwent neuropsychological examination prior to and 1 year after surgery. A control group (n = 52) of healthy volunteers matched for age, sex, and education underwent the same examination. Assessments included executive, memory, and motor functions with standardized testing. Patients with convexity meningiomas were clinically assessed for parietal association cortex functions. results All patients performed significantly worse (p < 0.05) in most neurocognitive domains than controls. The skull base group showed more disturbances in memory than the convexity group (p < 0.05). The anterior convexity group showed more deficits in executive function than the posterior convexity group, which presented with parietal association cortex deficits. Verbal deficits were more pronounced in the left hemisphere than in the right hemisphere. Patients with a large tumor (> 4 cm) had more severe neurocognitive deficits than those with a small tumor (< 4 cm). Postoperatively, patients showed no deterioration in neurocognitive function. Instead, significant improvement (p < 0.05) was observed in some executive, motor, and parietal association cortex functions. coNclusioNs According to the authors' findings, intracranial meningiomas may cause neurocognitive deficits in patients. Surgery does not cause a deterioration in cognitive function; instead, it may lead to improvements in some functions. Permanent neuropsychological postoperative deficits should be interpreted as tumor-induced rather than due to surgery.

Pattern of intracranial tumours in a tertiary hospital in Ghana

“…97.3% of meningiomas were located in the supratentorial region and convexity meningioma (40.5%) predominated, followed by sphenoid wing (21.6%) and parasagittal meningiomas (16.2%) respectively. This is similar to the study by Evangelia et al 21 Tuberculoma have been reported to mimic malignant tumours [22][23][24] but we have not found this among our patients in this series. The crude incidence rate of intracranial tumour in this study was 1.34 per 100,000 populations per year.…”

Health-related quality of life of cranial WHO grade I meningioma patients: are current questionnaires relevant?

“…Issues in the cognitive domain (e.g., concentration problems) were rated as important by skull base meningioma patients, but not by convexity meningioma patients. This is in line with previous studies that showed that skull base meningioma patients had significantly more problems than patients with a convexity meningioma in the cognitive domain (memory, verbal memory, information processing and psychomotor speed) [ 9 , 19 ]. This could possibly be explained by the anatomical proximity of these tumors to the temporal lobe, which is known to support memory function [ 35 ].…”

Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma

“…Other studies have largely focused on specific deficits or tumor locations, leading to small sample sizes with less generalizable results. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]28 Our study concludes that there are preoperative factors that can predispose patients to higher risks of postoperative deficits, allowing providers to consider these when planning for surgery and postoperative care. While we believe this study provides the most relevant information concerning postoperative deficits from meningioma removal, the study is not without limitations.…”

“…3 Previous studies that have evaluated postoperative complications and deficits following meningioma surgery have only focused on a single location or a type of surgical complication. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] It therefore remains unclear how meningiomas in different locations differ in terms of postoperative complications and the factors that predispose to these complications. This is especially important as the incidence of meningiomas is rising as a result of widespread availability of neuroimaging.…”