Poor Brain–Tumor Interface–Related Edema Generation and Cerebral Venous Decompensation in Parasagittal Meningiomas

Yin, Tengkun; Zhang, Jianhe; Zhang, Hao; Zhao, Qingshuang; Wei, Liangfeng; Wang, Shousen

doi:10.1016/j.wneu.2018.04.092

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Furthermore, it is not recommended to perform direct ligation and resection of the superior sagittal sinus without assessing whether the local drainage vein is well compensated, even if preoperative imaging indicates type III. When preoperative symptoms of venous hypertension are under consideration, along with imaging indicating a scarcity of side drainage veins around the tumor, characterized by small venous vessel diameters and a singular drainage pattern, or when peritumoral brain edema (PTBE) coincides with poor brain-tumor interface-related edema (PIRE) ( 14 , 15 ), there is a likelihood of insufficient local compensatory drainage veins. Hence, reconstruction of the sinus cavity warrants consideration ( Figure 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, preoperative imaging of the sinus does not *Simpson grade II resection is defined as electrocoagulation only with complete or partial preservation of the sinus wall to avoid affecting the collateral veins. drainage pattern, or when peritumoral brain edema (PTBE) coincides with poor brain-tumor interface-related edema (PIRE) (14,15), there is a likelihood of insufficient local compensatory drainage veins. Hence, reconstruction of the sinus cavity warrants consideration (Figure 4).…”

Section: Assessment Identification and Protection Of The Sagittal Sin...mentioning

confidence: 99%

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Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Duan,

Zhou,

Yan

et al. 2024

Front. Neurol.

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BackgroundNo standardized criteria for surgical resection of parasagittal sinus meningiomas (PSM) have been established, and different surgical strategies have been proposed. The aim of the present study was to investigate the efficacy and safety of a “radical” surgical strategy in the treatment of PSM.MethodsThe clinical histories, radiological findings, pathologic features, and surgical records of 53 patients with PSM admitted by the same surgical team using the “radical” surgical strategy were retrospectively analyzed between 2018 and 2023.ResultsAmong the 53 PSM cases, 16 (30.2%) had a patent sinus proper, 28 (52.8%) had partial obstruction of the sinus proper, and 9 (17.0%) had complete obstruction of the sinus proper before the operation. During operation, Simpson grade I resection was performed in 34 (64.2%) cases and Simpson grade II in 19 (35.8%) cases. Postoperative pathologic examination suggested tumors of WHO grade I in 47 (88.7%) cases, WHO grade II in 4 (7.5%) cases, and WHO grade III in 2 (3.8%) cases. Postoperative complications primarily included a small amount of delayed intracerebral hemorrhage in 3 (5.7%) cases, exacerbation of cerebral edema in 3 (5.7%) cases, exacerbation of motor and sensory deficits in 4 (7.5%) cases, and intracranial infection in 2 (3.8%) cases. There were no cases of death or new-onset neurological dysfunction. Dizziness and headache symptoms improved to varying degrees, and a seizure-free status was achieved postoperatively. Excluding one case lost to follow-up, the average follow-up period was 33 months, and there were no cases of recurrence.ConclusionA “radical” strategy for the surgical management of PSM is effective, safe, and simple to perform, provided that the sagittal sinus is properly managed and its associated veins are protected.

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Section: Discussionmentioning

confidence: 99%

Section: Assessment Identification and Protection Of The Sagittal Sin...mentioning

confidence: 99%

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Duan,

Zhou,

Yan

et al. 2024

Front. Neurol.

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“…Whether a correlation exists between peritumor edema and meningioma grade is controversial. The etiology of peritumor edema remains unclear, and peritumor venous congestion or ischemia has become the mainstreamview ( 24 ). Some studies have demonstrated that peritumor edema is an important feature of atypical meningioma or malignant meningioma, whereas other studies have also noted that a relationship exists between peritumor edema and meningioma grade.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic nomogram model for predicting preoperative pathological grade of meningioma

Peng¹,

Cheng²,

Guo³

2021

Transl Cancer Res TCR

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Background: Meningioma is the most common primary tumor of the central nervous system. Preoperative diagnosis of high-grade meningioma is helpful for the selection of treatment options. The aim of our study is to establish a diagnostic nomogram model for preoperative prediction of the pathological grade of meningioma.Methods: The predictive model was established from a cohort of 215 clinicopathologically confirmed meningioma between January 2012 and December 2017. Radiomic features were collected from preoperative magnetic resonance imaging (MRI) and computed tomography of patients with meningioma. The least absolute shrinkage and selection operator (LASSO) regression model was used for data dimension reduction and feature selection. Multivariate logistic regression was used to build a predictive model and presented as a nomogram. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Internal validation was evaluated using bootstrapping validation.Results: High-grade meningioma was observed in 47 patients (22%). The predictors included in the nomogram were tumor-brain interface, bone invasion, and tumor location. The final diagnostic model exhibited good calibration and discrimination with a C-index of 0.874 (95% confidence interval: 0.818-0.929) and a higher C-index of 0.868 in internal validation. Decision curve analysis (DCA) indicated that the nomogram is very useful in clinical practice. Conclusions:This study provides a nomogram model with tumor-brain interface, bone invasion, and tumor location that can effectively predict the preoperative pathological grading of patients with meningioma and thus help clinicians provide more reasonable treatment strategies for meningioma patients.

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“…They concluded that PIRE was highly associated with venous decompensation and worst neurological outcome within the consequent three to six months. Despite the fact that, their topic was the contribution of venous drainage insufficiency to edema formation they stressed the role of brain tumor interface and venous network [14].…”

Section: Yin Et Al Published a Study Of Edema In Parasagittal Meningiomas Focusing On Venous Compression Theorymentioning

confidence: 99%

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

Antoniades¹,

Stamatiou²,

Papadopoulou³

et al. 2020

J Neurol Exp Neurosci

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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.

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Poor Brain–Tumor Interface–Related Edema Generation and Cerebral Venous Decompensation in Parasagittal Meningiomas

Cited by 7 publications

References 21 publications

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Efficacy and safety of a “radical” surgical strategy in the treatment of parasagittal sinus meningioma

Diagnostic nomogram model for predicting preoperative pathological grade of meningioma

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

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