Perioperative Brain Edema in Meningioma Resection Procedures: Case Series and Experience of a Single Center

Abstract

Meningiomas are the most frequent benign intracranial lesions. They arise from the arachnoidal cap cells and are extra-axially located. Gross total resection in most of the cases is the treatment of choice. Technical aspects such as the presence of perifocal edema renders the resection procedure difficult and are related to postoperative outcome. Edema is not associated with location and size alone. It constitutes actually a phenomenon of the tumor and adjacent brain parenchyma interface and also depends on the secretion of vascular proliferations factors. Herewith, we present our retrospective study concerning 57 patients, who were operated, within the last eighteen months in our tertiary neurosurgical center. In our findings we involved tumor location and histological type. The grade of resection was described according to Simpson's scale and arachoidal plane was evaluated on T2-WI and FLAIR sequences. Furthermore, we have established statistical correlations of neurological outcome utilizing modified Rankin Scale upon the first two months, based on edema index (p < 0.008), arachnoidal plane presence (p < 0.0001) and the extent of excision (p < 0.003), as well. We advocate that surgeon should thoroughly examine the preoperative radiological tools and plan safely the strategy of extirpation beginning from the arachnoidal cleft.