Factors Influencing Morbidity and Mortality After Cranial Meningioma Surgery — a Multivariate Analysis

Meixensberger, Jürgen; Meister, Tobias; Janka, Michael; Haubitz, B.; Bushe, K.-A.; Roosen, K.

doi:10.1007/978-3-7091-9450-8_27

Cited by 14 publications

(20 citation statements)

References 6 publications

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“…1,3–6,8,9,11,12,18–22,25,26,28–30,35–38,40,41,43,48,51–53,55,59,60, 62–64,68–70 All investigations were retrospective observational case series, and no prospective controlled trials were identified.…”

Section: Resultsmentioning

confidence: 99%

Seizures in supratentorial meningioma: a systematic review and meta-analysis

Englot¹,

Magill²,

Han³

et al. 2016

JNS

130

109

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Object Meningioma is the most common benign intracranial tumor, and patients with supratentorial meningioma frequently suffer from seizures. The rates and predictors of seizures in patients with meningioma have been significantly under-studied, even in comparison with other brain tumor types. Improved strategies for the prediction, treatment, and prevention of seizures in patients with meningioma is an important goal, because tumor-related epilepsy significantly impacts patient quality of life. Methods The authors performed a systematic review of PubMed for manuscripts published between January 1980 and September 2014, examining rates of pre- and postoperative seizures in supratentorial meningioma, and evaluating potential predictors of seizures with separate meta-analyses. Results The authors identified 39 observational case series for inclusion in the study, but no controlled trials. Preoperative seizures were observed in 29.2% of 4709 patients with supratentorial meningioma, and were significantly predicted by male sex (OR 1.74, 95% CI 1.30–2.34); an absence of headache (OR 1.77, 95% CI 1.04–3.25); peritumoral edema (OR 7.48, 95% CI 6.13–9.47); and non–skull base location (OR 1.77, 95% CI 1.04–3.25). After surgery, seizure freedom was achieved in 69.3% of 703 patients with preoperative epilepsy, and was more than twice as likely in those without peritumoral edema, although an insufficient number of studies were available for formal meta-analysis of this association. Of 1085 individuals without preoperative epilepsy who underwent resection, new postoperative seizures were seen in 12.3% of patients. No difference in the rate of new postoperative seizures was observed with or without perioperative prophylactic anticonvulsants. Conclusions Seizures are common in supratentorial meningioma, particularly in tumors associated with brain edema, and seizure freedom is a critical treatment goal. Favorable seizure control can be achieved with resection, but evidence does not support routine use of prophylactic anticonvulsants in patients without seizures. Limitations associated with systematic review and meta-analysis should be considered when interpreting these results.

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Section: Resultsmentioning

confidence: 99%

Seizures in supratentorial meningioma: a systematic review and meta-analysis

Englot¹,

Magill²,

Han³

et al. 2016

JNS

130

109

View full text Add to dashboard Cite

show abstract

“…5 Overall, little is known of prognostic factors influencing morbidity and mortality after intracranial meningioma surgery. 6 The aim of this study was to determine the implication of PTBE in the prognosis of intracranial meningiomas.…”

Section: Introductionmentioning

confidence: 99%

Peritumoral edema and prognosis in intracranial meningioma surgery

Vignes

Sesay

Rezajooi

et al. 2008

Journal of Clinical Neuroscience

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“…Our 6-month mortality rate (20%) is higher than most reported rates (7-19.3%). [5][6][7][8]10,11,18 Four of the deaths recorded in the present study were due to brain swelling and rostro-caudal herniation during the first 1-2 weeks of surgery. All the patients presented after 3 years of onset (considered as late presentation) with signs and symptoms of raised intracranial pressure and, on CT, large tumours (>50 mm) bordered by grade 3 peritumoural oedema.…”

Section: Discussionmentioning

confidence: 99%

“…Of age, sex, tumour size, location, vascularity, oedema and histology, Alaywan and Sindou 8 found severity of preoperative neurological conditions and tumour size to be the only predictors of adverse outcome, including morbidity and mortality, and stressed the additional role of vascular supply from the pia mater. 9 Djindjian et al 10 also found that preoperative clinical status (including a Karnofsky rating of less than 50), peritumoural oedema and mass effect are essential parameters for quantifying surgical risk, while in the series of Meixensberger et al, 11 age, poor preoperative clinical condition (ASA [American Society of Anesthetists] score), intra-and postoperative bleeding and cerebrospinal fluid disturbances were significantly associated with a subsequent decrease of quality of life.…”

Section: Introductionmentioning

confidence: 93%