Preoperative Neuroimage Findings as a Predictor of Postoperative Neurological Deficit in Intracranial Meningiomas
| Autor: | F. Kramár, David Netuka, František Charvát, P. Kozler, Vladimír Beneš |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Brain Edema Neuropsychological Tests Meningioma Postoperative Complications Eloquent cortex Predictive Value of Tests otorhinolaryngologic diseases medicine Humans Neurological findings Longitudinal Studies Prospective Studies Aged Neurological deficit business.industry Angiography Digital Subtraction Subtotal Resection Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Patient need Invasive growth Cohort Disease Progression Female Neurology (clinical) Nervous System Diseases business Algorithms |
| Zdroj: | Zentralblatt für Neurochirurgie - Central European Neurosurgery. 68:190-194 |
| ISSN: | 1438-9746 0044-4251 |
| Popis: | BACKGROUND The present study aimed to find radiological parameters that can provide indirect information on the invasive growth of meningioma relevant enough to predict the likely risk of postoperative neurological deficit. MATERIAL/METHODS The cohort consisted of 40 consecutive adult patients (from January 2004 till May 2005) with comparable general condition parameters (age 18-75 years, KRS 70-100, ASA 1-2) with meningiomas solely attacking brain tissue with the whole of their volume. The Pearson chi-square test was used for statistical evaluation. RESULTS Radical resection of the meningioma was attained in 33 (82.5%) patients and subtotal resection in 7 (17.5%). Ten (25%) patients at 7 days after the operation had neurological findings which were worse than before. Seven were found to have a new neurological deficit and there were three cases of progression of the existing neurological symptoms. Three patients (7.5%) were worse off neurologically than before the operation as long as 3 months after surgery, while seven had their neurological condition restored ad integrum. All of the ten patients with postoperatively worsened neurological findings had their meningiomas localised in the eloquent area. A correlation was found between the eloquent area and neurological deficits, and also between the presence of peritumoral oedema (small, medium, large) and neurological deficits. Interdependence was detected between a discernible tumour-brain interface and the absence of oedema, between a discernible tumour-brain interface and a dural type of vascular supply, and between the dural type of vascularisation and an absence of oedema. CONCLUSIONS As follows from the outcomes, meningioma growth in the eloquent area and the presence of peritumoral oedema are the two adverse parameters predicting the development of postoperative neurological deficits. In contrast, dural types of vascularisation, a visible tumour-brain interface, meningioma growing in a non-eloquent area, and the absence of peritumoral oedema are favourable predictive parameters. To go by the results, in the presence of the last two parameters the patient need not be exposed to the risks of invasive selective angiography. |
| Databáze: | OpenAIRE |
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