Intracranial meningiomas and seizures: a review of the literature

Hai, Xue; Sveinsson, Ólafur; Tomson, Torbjörn; Mathiesen, Tiit

doi:10.1007/s00701-015-2495-4

Cited by 34 publications

(24 citation statements)

References 55 publications

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“…Moreover, Mantle et al 11 reported a strong association between brain-invasive growth and PTBE, which is one of the main risk factors for the development of perioperative seizures. 4,6,12,23 In the same series, the authors found a 20% increase in the incidence of brain invasion with each 1-cm increase in edema. 11 Disruption of cortical integrity by infiltrating meningioma cells with subsequent astrocytic response 24 might also impair neurological function and contribute to an increased risk of seizures in patients with brain-invasive meningioma.…”

Section: Discussionmentioning

confidence: 78%

“…The frequency of preoperative seizures in our study was 19%, which is in line with the broad range of incidences reported from previous analyses. 4,6,12,23 According to findings in macroscopically detected brain-invasive meningiomas, 5 the incidence of preoperative seizures was distinctly higher in patients with a microscopically detected brain-invasive meningioma than in those with a noninvasive meningioma. Correspondingly, seizures were more common in patients with a high-grade than in those with a benign meningioma.…”

Section: Brain Invasion and The Risk Of Preoperative Seizuresmentioning

confidence: 99%

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Brain invasion and the risk of seizures in patients with meningioma

Heß

Spille²,

Adeli

et al. 2019

Journal of Neurosurgery

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OBJECTIVE Identification of risk factors for perioperative epilepsy remains crucial in the care of patients with meningioma. Moreover, associations of brain invasion with clinical and radiological variables have been largely unexplored. The authors hypothesized that invasion of the cortex and subsequent increased edema facilitate seizures, and they compared radiological data and perioperative seizures in patients with brain-invasive or noninvasive meningioma. METHODS Correlations of brain invasion with tumor and edema volumes and preoperative and postoperative seizures were analyzed in univariate and multivariate analyses. RESULTS Totals of 108 (61%) females and 68 (39%) males with a median age of 60 years and harboring totals of 92 (52%) grade I, 79 (45%) grade II, and 5 (3%) grade III tumors were included. Brain invasion was found in 38 (22%) patients and was absent in 138 (78%) patients. The tumors were located at the convexity in 72 (41%) patients, at the falx cerebri in 26 (15%), at the skull base in 69 (39%), in the posterior fossa in 7 (4%), and in the ventricle in 2 (1%); the median tumor and edema volumes were 13.73 cm (range 0.81-162.22 cm) and 1.38 cm (range 0.00-355.80 cm), respectively. As expected, edema volume increased with rising tumor volume (p < 0.001). Brain invasion was independent of tumor volume (p = 0.176) but strongly correlated with edema volume (p < 0.001). The mean edema volume in noninvasive tumors was 33.0 cm, but in invasive tumors, it was 130.7 cm (p = 0.008). The frequency of preoperative seizures was independent of the patients' age, sex, and tumor location; however, the frequency was 32% (n = 12) in patients with invasive meningioma and 15% (n = 21) in those with noninvasive meningioma (p = 0.033). In contrast, the probability of detecting brain invasion microscopically was increased more than 2-fold in patients with a history of preoperative seizures (OR 2.57, 95% CI 1.13-5.88; p = 0.025). In univariate analyses, the rate of preoperative seizures correlated slightly with tumor volume (p = 0.049) but strongly with edema volume (p = 0.014), whereas seizure semiology was found to be independent of brain invasion (p = 0.211). In multivariate analyses adjusted for age, sex, tumor location, tumor and edema volumes, and WHO grade, rising tumor volume (OR 1.02, 95% CI 1.00-1.03; p = 0.042) and especially brain invasion (OR 5.26, 95% CI 1.52-18.15; p = 0.009) were identified as independent predictors of preoperative seizures. Nine (5%) patients developed new seizures within a median follow-up time of 15 months after surgery. Development of postoperative epilepsy was independent of all clinical variables, including Simpson grade (p = 0.133), tumor location (p = 0.936), brain invasion (p = 0.408), and preoperative edema volume (p = 0.081), but was correlated with increasing preoperative tumor volume (p = 0.004). Postoperative seizure-free rates were similar among patients with invasive and those with noninvasive meningioma (p = 0.372). CONCLUSIONS Brain invasion was identified as a new an...

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Section: Discussionmentioning

confidence: 78%

Section: Brain Invasion and The Risk Of Preoperative Seizuresmentioning

confidence: 99%

Brain invasion and the risk of seizures in patients with meningioma

Heß

Spille²,

Adeli

et al. 2019

Journal of Neurosurgery

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“…[10] Yine semptomlu menenjiomların %40'dan fazlası ameliyattan önce nöbet ile prezente oldukları saptanmıştır. [6] Bizim çalışmamızda kranyal intrakraniyal cerrahi geçiren hastalarda nöbet etiyolojisinde YKL'ler ilk sırayı almış olup bunu BDH ve travmalar ikinci sıklıkla takip etmiştir. Beyin tümörlü hastaların yaklaşık %30'unda ilk semptomu nöbettir.…”

Section: Discussionunclassified

“…[5] Literatürde semptomlu menenjiomların %40'dan fazlasının ameliyattan önce nöbet ile prezente oldukları saptanmıştır. [6] Kafa travmasının, çeşitli spektrumlarda motor ve kognitif özürlülük gelişimine neden olabildiği, nöbetlerin ise sık ortaya çıkan komplikasyonu olduğu bildirilmiştir. [7] Yapılan çalışmada cerrahi sonrası nöbet gelişimi açısından risk faktörleri olarak ameliyat öncesi nöbet olması, tümörün yeri, geniş tümör rezeksiyonu belirtilmiştir.…”

Section: Introductionunclassified

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Epilepsy due to Intracranial Surgery: 15 Years of Experience

Akdağ¹

2016

Epilepsi

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Objectives: Epidemiological studies have shown increased incidence of epilepsy in cases of brain trauma, central nervous system infection, cerebrovascular disease (CVD), and brain tumors. Etiology of epilepsy varies according to age. In the etiology of partial and secondarily generalized partial seizures in adult patients, CVD is the most common cause of acute, symptomatic seizures. Frequency of seizures is estimated to be 15%-20% after cranial operations. In this study, characteristics of patients undergoing cranial surgery were investigated retrospectively. Methods:Eighty-four patients who were admitted to epilepsy clinic between 2000 and 2015 with history of cranial surgery and symptomatic seizures were included in the present study.Results: Etiology indications were 41 cases of (48.8%) space-occupying lesions, 19 (22.6%) instances of trauma, 19 (22.6%) cases of CVD, and 5 (6.0%) with ventriculoperitoneal shunt. Preoperative seizures had been observed in 17 (20.2%) of patients. No seizure was seen in 11 (13.1%) patients. EEG findings revealed focal abnormalities in 39 (46.4%) patients and were normal in 26 (31.0%) patients. Total of 43 (51.2%) patients were treated with monotherapy, and 32 (38.1%) patients were under polytherapy.Conclusion: Most common etiological factors for patients with pre/postoperative epilepsy who underwent cranial surgery were spaceoccupying lesions. Occurrence of seizures may be delayed. EEG results indicated focal findings most often in cases of lesions. Patients were seen to respond well to treatment of seizures with monotherapy. ÖzetAmaç: Epidemiyolojik çalışmalar beyin travmaları, santral sinir sistemi (SSS) enfeksiyonu, beynin damarsal hastalığı (BDH) ve beyin tümörlerinin epilepsi insidansını artırdığını göstermiştir. Epilepsi etiyolojisi yaşlara göre değişiklik göstermektedir. Yetişkin hastalarda sekonder jeneralize ve parsiyel nöbetlerin etiyolojisinde en sık serebrovasküler hastalık yer almaktadır. Ayrıca kranyal operasyon sonrası nöbetlerin sıklığı %15-20 olduğu tahmin edilmektedir. Bu çalışmada, kranyal cerrahi geçiren hastaların özellikleri geriye dönük olarak araştırıldı. Gereç veYöntem: Çalışmamıza 2000-2015 yılları arasında epilepsi polikliniğimize başvuran, semptomatik epilepsi nedeniyle cerrahi öyküsü olan 84 hasta dahil edildi. Diğer semptomatik nöbet geçiren hastalar ve epilepsi cerrrahisi yapılan hastalar çalışmaya alınmadı. Bulgular: Etiyolojide 41 kişide (%48.8) yer kaplayan lezyon (YKL) ilk sırada iken, 19 (%22.6) kişide travma, 19 (%22.6) kişide beyin damar hastalıkları (BDH), 5 (%6.0) kişide ventriküloperitoneal şant (VPŞ) görülmekteydi. On yedi (%20.2) hastada ameliyat öncesi dönemde nöbet gözlendi. On bir (%13.1) hastada nöbet görülmedi. Elektroensefalografi (EEG) bulguları 39 (%46.4) hastada fokal bulgular saptanırken, 26 (%31.0) hastada normal idi. Kırk üç (%51.2) hasta monoterapi, 32 (%38.1) hasta politerapi altındaydı.Sonuç: Kranyal cerrahi geçiren ameliyat öncesi/sonrası epilepsili hastalarda en sık görülen etiyolojik nedenin yer kaplayan lezyonlar olduğ...

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Intracranial intricacies: Comprehensive analysis of rare skull base meningiomas—A single‐center case series

Nadeem,

Khan,

Habib

et al. 2023

Clinical Case Reports

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Key Clinical MessageThis study paper's main goal is to report rare cases of skull base meningiomas that exemplify the complexities of diagnosis, therapy, and postoperative care. By describing these rare cases, we hope to advance knowledge of the clinical signs, difficulties, and prognoses of skull base meningiomas in a challenging anatomical setting. In the posterior cranial fossa, our investigation reveals a unique example of skull base meningioma that involved numerous cranial nerves and complex vasculature. A variety of visual abnormalities were present in the patient's clinical presentations, highlighting the wide range of symptoms that these tumors might cause depending on their precise positions. These cases highlight the critical importance of preoperative imaging, including high‐resolution MRI and angiography, as well as the diagnostic difficulties these tumors pertain. By reporting these instances, our research adds to the body of knowledge about skull base meningiomas and offers insightful information about the nuances of their therapies. Our findings highlight the importance of individualized treatment plans, interdisciplinary cooperation, and the demand for continued study to better comprehend these convoluted tumors. Such studies are essential for advancing our knowledge of these enigmatic tumors, guiding clinical judgment, and eventually improving patient outcomes. These findings are important because they can fill information gaps, improve treatment plans, and encourage additional research in neuro‐oncology.AbstractThis study presents a series of three rare cases of skull base meningiomas, emphasizing the complexities in diagnosis, treatment, and postoperative care. The patients' clinical presentations and imaging highlighted the diverse symptoms and challenges associated with these tumors, found in intricate anatomical locations. The cases underscore the crucial role of preoperative high‐resolution imaging and angiography in diagnostic accuracy. Surgical intervention, guided by a multidisciplinary approach, is pivotal in managing these demanding cases. Histopathological examinations confirmed atypical meningiomas. The postoperative phases involved meticulous care to ensure optimal recovery and functional outcomes. Our findings contribute to the understanding of skull base meningiomas, emphasizing the need for personalized treatment plans and ongoing research to improve patient outcomes in neuro‐oncology.

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Intracranial meningiomas and seizures: a review of the literature

Abstract: Seizures are a common manifestation of meningiomas, but about 80 % patients with preoperative seizures can be seizure free after tumor removal. Prospective controlled AED trials specifically on meningioma patients are much needed.

Cited by 34 publications

References 55 publications

Brain invasion and the risk of seizures in patients with meningioma

Brain invasion and the risk of seizures in patients with meningioma

Epilepsy due to Intracranial Surgery: 15 Years of Experience

Intracranial intricacies: Comprehensive analysis of rare skull base meningiomas—A single‐center case series

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