Prognostic Implication of Preoperative Behavior Changes in Patients with Primary High-Grade Meningiomas

Abstract

High-grade meningiomas are rare extra-axial tumors, frequently causing brain invasion and prominent brain edema. Patients harboring high-grade meningiomas occasionally present with behavior changes. Data about frequency and prognostic importance of preoperative behavior changes in patients with high-grade meningiomas is missing. 86 patients with primary high-grade meningiomas were analyzed. Statistical analysis was performed to determine correlation of preoperative behavior changes with tumor location, preoperative brain edema, tumor cleavability, tumor grade, Ki67 proliferation index, and microscopic brain invasion. Survival analysis was performed. 30 (34.9%) patients presented with preoperative behavior changes. These changes were more frequent with male patients (P = 0.066) and patients older than 55 years (P = 0.018). They correlated with frontal location (P = 0.013), tumor size (P = 0.023), microscopic brain invasion (P = 0.015), and brain edema (P = 0.006). Preoperative behavior changes did not correlate with duration of symptoms, tumor cleavability, tumor malignancy grade, and Ki67 proliferation index. They were not significantly related to overall survival or recurrence-free survival of patients with primary high-grade meningiomas. Preoperative behavior changes are frequent in patients harboring primary high-grade meningiomas. They correlate with tumor size, microscopic brain invasion, and brain edema. Preoperative behavior changes do not predict prognosis in patients with primary high-grade meningiomas.

Prevalence and Trends in the Neuropsychological Burden of Patients having Intracranial Tumors with Respect to Neurosurgical Intervention

“…These are found to be associated with brain edema, tumor size, and microscopic invasion of the tumor. But there was no association of these symptoms with the prognosis of the patients [20] . Neuropsychological symptoms of the patients with an intracranial tumor may be impacted by the treatment modalities like surgery, chemotherapy, radiotherapy, or ventriculoperitoneal shunt [3,[21][22][23] .…”

The Effects of Closed-Loop Brain Implants on Autonomy and Deliberation: What are the Risks of Being Kept in the Loop?

“…More work is required to fully comprehend the ethical concerns associated with being kept in the loop, as it may share a limited number of concerns with other novel invasive brain technologies or other types of neuro-interventions. 44,45,46,47,48,49,50,51 A further important question to explore would be whether bypassing implanted individual consent by allowing a system to deliver an automated therapeutic response could be ethically acceptable in some cases.…”

Brain invasion and the risk of seizures in patients with meningioma

“…1,10,15 However, although correlations between brain invasion and tumor progression are being widely investigated, data regarding the association of brain invasion with radiological findings and patient symptoms are currently sparse. 1 Vranic and Gilbert 22 found increased rates of behavioral changes in patients with microscopically detected brain-invasive meningioma. 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.…”