Microsurgical treatment of parafalcine meningiomas: a retrospective study of 126 cases

Kong, Xiangyi; Gong, Shusheng; Lee, Ivan; Yang, Yi

doi:10.2147/ott.s162274

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…The result that numerous lesions located at the middle third of the sagittal plane was reported in another study and was associated with a high risk of perioperative complications ( 21 ). The key points of surgery of these lesions were handling the feeding artery, protecting the central sulcus vein, and treating affected sagittal sinus ( 22 ). The distinct distribution in these areas could be explained by regionally thick arachnoid membranes with high risk of developing neoplasms.…”

Section: Discussionmentioning

confidence: 99%

The Preferred Locations of Meningioma According to Different Biological Characteristics Based on Voxel-Wise Analysis

Sun

Dou

et al. 2020

Front. Oncol.

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Objective: Meningiomas presented preferred intracranial distribution, which may reflect potential biological natures. This study aimed to analyze the preferred locations of meningioma according to different biological characteristics. Method: A total of 1,107 patients pathologically diagnosed with meningiomas between January 2012 and December 2016 were retrospectively analyzed. Preoperative MRI were normalized, and lesions were semiautomatically segmented. The stereospecific frequency and p value heatmaps were constructed to compare two biological phenotypes using two-tailed Fisher's exact test. Age, sex, WHO grades, extent of resection (EOR), recurrence, and immunohistochemical markers including p53, Ki67, epithelial membrane antigen (EMA), progesterone receptor (PR), and CD34 were statistically analyzed. Recurrence-free survival (RFS) were analyzed by Kaplan-Meier method. Result: Of 1,107 cases, convexity (20.8%), parasagittal (16.1%), and falx (11.4%) were the most predominant loci of meningiomas. The p-value heatmap suggested lesion predominance in the left frontal and occipital convexity among older patients while in the left sphenoid wing, and right falx, parasellar/cavernous sinus, and middle fossa among younger patients. Lesions located at anterior fossa and frontal structures were more frequently seen in the male while left parietal falx and tentorial regions, and right cerebellopontine angle in the female. Grades II and III lesions presented predominance in the frontal structures compared with grade I ones. Meningiomas at the left parasagittal sinus and falx, tentorium, intraventricular regions, and skullbase structures were significantly to receive subtotal resection. Lesions with p53 positivity were statistically located at the left frontal regions and parasellar/cavernous sinus, higher Ki67 index at the left frontal and bilateral parietal convexity and right parasellar/cavernous sinus, EMA negativity at the right olfactory groove and left middle fossa, and CD34 positivity at the sellar regions and right sphenoid wing. Tumor recurrence rates for grades I, II, and III were 2.8, 7.9, and 53.8%, respectively. Inferior RFS, higher Sun et al. The Preferred Locations of Meningioma Ki67 index, grades II and III, and a larger preoperative volume were observed in older patients. Recurrent meningiomas were more frequently found at the occipital convexity, tentorium, sellar regions, parasagittal sinus, and left sphenoid wing. Conclusion: The preferred locations of meningioma could be observed according to different biological characteristics, which might be helpful for clinical decisions.

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Section: Discussionmentioning

confidence: 99%

The Preferred Locations of Meningioma According to Different Biological Characteristics Based on Voxel-Wise Analysis

Sun

Dou

et al. 2020

Front. Oncol.

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“…Postoperative hematoma requiring evacuation occurred in 5 cases, and there was no mortality. 17 In a series of 58 patients with PFPS meningiomas, new neurological deficits occurred at a rate of 5.2%, and the total complication rate reported was 8.6%. Tumor growth or recurrence was noted in 3.4% of patients.…”

Section: Surgical Resection Of Pfps Meningiomasmentioning

confidence: 97%

“…However, in single-center studies including both symptomatic and asymptomatic PFPS meningiomas, resection was associated with up to 19% complication rate 6 and up to 3% mortality rate. [17][18][19] In a series of 100 consecutive patients with meningiomas around the major sinuses, postoperative complications included pulmonary embolism (1%), sepsis (6%), and permanent neurologic deterioration because of venous infarction (8%). Postoperative hematoma requiring evacuation occurred in 3 patients (3%), and the mortality rate was 3%.…”

Section: Surgical Resection Of Pfps Meningiomasmentioning

confidence: 99%

Stereotactic Radiosurgery Compared With Active Surveillance for Asymptomatic, Parafalcine, and Parasagittal Meningiomas: A Matched Cohort Analysis From the IMPASSE Study

et al. 2022

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BACKGROUND:The optimal management of asymptomatic, presumed WHO grade I meningiomas remains controversial. OBJECTIVE: To define the safety and efficacy of stereotactic radiosurgery (SRS) compared with active surveillance for the management of patients with asymptomatic parafalcine/ parasagittal (PFPS) meningiomas. METHODS: Data from SRS-treated patients from 14 centers and patients managed conservatively for an asymptomatic, PFPS meningioma were compared. Local tumor control rate and new neurological deficits development were evaluated in the active surveillance and the SRS-treated cohorts. RESULTS: There were 173 SRS-treated patients and 98 patients managed conservatively in the unmatched cohorts. After matching for patient age and tumor volume, there were 98 patients in each cohort. The median radiological follow-up period was 43 months for the SRS cohort and 36 months for the active surveillance cohort (P = .04). The median clinical follow-up for the SRS and active surveillance cohorts were 44 and 36 months, respectively. Meningioma control was noted in all SRS-treated patients and in 61.2% of patients managed with active surveillance (P < .001). SRS-related neurological deficits occurred in 3.1% of the patients (n = 3), which were all transient. In the active surveillance cohort, 2% of patients (n = 2) developed neurological symptoms because of tumor progression (P = 1.0), resulting in death of 1 patient (1%). CONCLUSION: Up-front SRS affords superior radiological PFPS meningioma control as compared with active surveillance and may lower the risk of meningioma-related permanent neurological deficit and/or death.

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“…Therefore, the accurate location of the falx meningioma is critically important for the success of surgical operation. 3 The key step is to visualize the spatial relationship between the falx meningioma and the surrounding blood vessels intraoperatively. 4 For the conventional preoperative procedures, two-dimensional (2D) magnetic resonance imaging (MRI) and computed tomography angiography (CTA) are used to visualize the falx meningioma and the adjacent blood vessels.…”

Section: Introductionmentioning

confidence: 99%

“…Any operation error may cause serious complications. Therefore, the accurate location of the falx meningioma is critically important for the success of surgical operation 3 . The key step is to visualize the spatial relationship between the falx meningioma and the surrounding blood vessels intraoperatively 4 …”

Section: Introductionmentioning

confidence: 99%

Marker‐less augmented reality based on monocular vision for falx meningioma localization

Deng

Liu

et al. 2021

Robotics Computer Surgery

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Background:The existing augmented reality (AR) based neuronavigation systems typically require markers and additional tracking devices for model registration, which causes excessive preparatory steps.Methods: For fast and accurate intraoperative navigation, this work proposes a marker-less AR system that tracks the head features with the monocular camera.After the semi-automatic initialization process, the feature points between the captured image and the pre-loaded keyframes are matched for obtaining correspondences. The camera pose is estimated by solving the Perspective-n-Point problem. Results:The localization error of AR visualization on scalp and falx meningioma is 0.417 � 0.057 and 1.413 � 0.282 mm, respectively. The maximum localization error is less than 2 mm. The AR system is robust to occlusions and changes in viewpoint and scale. Conclusions:We demonstrate that the developed system can successfully display the augmented falx meningioma with enough accuracy and provide guidance for neurosurgeons to locate the tumour in brain.

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Microsurgical treatment of parafalcine meningiomas: a retrospective study of 126 cases

Cited by 7 publications

References 7 publications

The Preferred Locations of Meningioma According to Different Biological Characteristics Based on Voxel-Wise Analysis

The Preferred Locations of Meningioma According to Different Biological Characteristics Based on Voxel-Wise Analysis

Stereotactic Radiosurgery Compared With Active Surveillance for Asymptomatic, Parafalcine, and Parasagittal Meningiomas: A Matched Cohort Analysis From the IMPASSE Study

Marker‐less augmented reality based on monocular vision for falx meningioma localization

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