scholarly journals The Most Significant Surgical Risk Factors of Giant Intracranial Meningiomas: Localization Matters Much More than Grading and Volume of Peritumoral Brain Edema. A Retrospective Clinical Neuroradiological and Immunohistochemical Study

2021 ◽  
Author(s):  
Daniele Armocida ◽  
Giuseppina Bevacqua ◽  
Antonia Catapano ◽  
Mauro Palmieri ◽  
Umberto Aldo Arcidiacono ◽  
...  
Keyword(s):  
Brain Edema ◽  
Large Diameter ◽  
Preoperative Imaging ◽  
Postoperative Phase ◽  
Consecutive Series ◽  
Surgical Risk ◽  
The Real ◽  
Intracranial Meningiomas ◽  
Significant Difference ◽  
Peritumoral Brain Edema

Abstract Background: Giant intracranial meningiomas (GIMs) are extremely rare and are usually considered arduous to resect totally with poorer prognosis. The real mechanisms by which a meningioma can grow to be defined as "giant" are unknown, as well as the real biological , radiological profile and the different outcomes.Methods: We performed a retrospective review of a consecutive series of surgically-treated patients suffering from intracranial Meningioma. All the patients were assigned on the ground of the preoperative imaging to the Giant and Medium/Large Meningiomas. We investigated whether the presence large diameter on radiological diagnosis is indicative for different mortality rate, grading, characteristic and clinical/neurological outcome.Results: The study shows that surgically treated giant meningiomas have a higher risk of developing complications in the postoperative phase (Chi square= 11.121, dF=1, p=0.001). The direct proportional relationship between peritumoral brain edema (PBE) volume and tumor volume was present only in the medium/large group and was not present in the giant meningioma group. When comparing the degree of performance there is a statistically significant difference between localization and KPS immediately postoperatively (p=0.04) particularly for sphenopetroclival meningiomas (p=0.071), and partially with GIM of the olfactory groove with arterial encasement. The most frequently encountered complications include the occurrence of ischemia (p=0.049), infection (p=0.03), and the occurrence of postoperative seizures.Conclusions: We identified that the major surgical risk factor for GIMs is location, where the petro-clival region and, to a lesser extent the anterior basicranium offer a greater risk of neurovascular involvement and arterial encasement. On other hand, the risk correlated with PBE is poorer in GIM although there is a well-noted correlation between the Edema volume and outcome in meningiomas.

Peritumoral Brain Edema in Intracranial Meningiomas: Effects of Radiological and Histological Factors

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1046-1052 ◽  
Author(s):  
Takashi Tamiya ◽  
Yasuhiro Ono ◽  
Kengo Matsumoto ◽  
Takashi Ohmoto
Keyword(s):  
Brain Edema ◽  
Intracranial Meningiomas ◽  
Peritumoral Brain Edema ◽  
Histological Factors

Peritumoral Brain Edema in Intracranial Meningiomas: Effects of Radiological and Histological Factors

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1046-1052 ◽  
Author(s):  
Takashi Tamiya ◽  
Yasuhiro Ono ◽  
Kengo Matsumoto ◽  
Takashi Ohmoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Relative Risk ◽  
Magnetic Resonance ◽  
Brain Edema ◽  
Blood Supply ◽  
Tumor Size ◽  
Resonance Imaging ◽  
Tumor Vascularity ◽  
Intracranial Meningiomas ◽  
Peritumoral Brain Edema

ABSTRACT OBJECTIVE We examined the radiological and histological features influencing the development of peritumoral brain edema (PTBE) among patients with meningiomas. METHODS Factors causing PTBE were retrospectively analyzed for 125 patients with primary intracranial meningiomas. These factors included tumor size, tumor location, brain-tumor interface, signal intensity on T2-weighted scans, contrast enhancement, and cyst formation (as observed on magnetic resonance imaging scans), as well as tumor vascularity and blood supply (as observed in digital subtraction angiography studies). We defined the edema/tumor volume ratio as the edema index, and we used this index to evaluate PTBE. RESULTS A relationship between the tumor size and the volume of PTBE was observed. Convexity and middle fossa meningiomas demonstrated the greatest increases in mean edema indices. Meningothelial, anaplastic, microcystic, and angiomatous subtypes exhibited higher edema indices than did other types. Multivariate analysis demonstrated two significant radiological factors: cortical penetration (as defined by the disappearance of the arachnoid layer on magnetic resonance imaging scans) (relative risk, 2.067;P = 0.0148) and vascular supply from the pial-cortical arteries (as observed on angiograms) (relative risk, 2.087;P = 0.0082). CONCLUSION Tumor infiltration into adjacent brain parenchyma and a pial-cortical blood supply are critical factors for the development of PTBE among patients with meningiomas.

Peritumoral brain edema in intracranial meningiomas

2005 ◽  
Vol 12 (7) ◽  
pp. 750-753 ◽  
Author(s):  
Doga Gurkanlar ◽  
Uygur Er ◽  
Metin Sanlı ◽  
Muhip Özkan ◽  
Zeki Sekerci
Keyword(s):  
Brain Edema ◽  
Intracranial Meningiomas ◽  
Peritumoral Brain Edema

scholarly journals Investigation of the Relationship Between the Degree of Peritumoral Brain Edema and Pathological Features of Glioma Before Surgery

2021 ◽  
Vol 18 (3) ◽  
Author(s):  
Zhenhua Wang ◽  
Xinlan Xiao
Keyword(s):  
Brain Edema ◽  
Malignant Tumors ◽  
Multivariate Logistic Regression Analysis ◽  
Expression Level ◽  
World Health ◽  
Low Grade ◽  
Ki 67 ◽  
Mutation Status ◽  
Significant Difference ◽  
Peritumoral Brain Edema

Background: Gliomas are the most common malignant tumors of the central nervous system (CNS). Preoperative prediction of the malignancy grade of gliomas are of particular importance. These tumors are often accompanied by peritumoral brain edema (PTBE). Previous studies have suggested that the degree of PTBE is an independent indicator of the prognosis of gliomas. Objectives: This study aimed to investigate the relationships between the degree of PTBE and the grade of glioma, isocitrate dehydrogenase 1 (IDH1) mutation status, and Ki-67 expression level in gliomas. Patients and Methods: In this retrospective cross-sectional study, a total of 82 patients were enrolled, according to the 2016 World Health Organization (WHO) classification of CNS tumors. Overall, 29 tumors were pathologically confirmed as low-grade gliomas (LGGs , grade I-II), whereas the remaining 53 tumors were classified as high-grade gliomas (HGGs, grade III-IV). The IDH1 mutations, Ki-67 expression, and magnetic resonance imaging (MRI) findings were retrospectively analyzed. The tumor and tumor + PTBE volumes were also measured, and the tumor edema index (EI) was calculated for each patient. Edema was then graded and correlated with the pathological parameters. Results: The degree of EI was higher in the HGG group compared to the LGG group, and the difference was statistically significant (z = -7.018, P < 0.05). Besides, the degree of EI was higher in the IDH1 wild-type compared with mutant groups (z = -4.116, P < 0.05). The degree of EI significantly associated with Ki-67 expression and patient’s age (P < 0.05), whereas there was no significant association between the degree of EI and gender (z = -0.497, P = 0.619). The Spearman’s correlation test revealed that the EI degree was positively correlated with the Ki-67 expression level and age, with correlation coefficients of 0.740 and 0.466, respectively. Moreover, the multivariate logistic regression analysis indicated that EI and IDH1 had significant effects on differentiating LGGs from HGGs (P < 0.05 for both). The receiver operating characteristic (ROC) curve analysis showed that EI was an optimal index for differentiating LGGs from HGGs, with an area under curve (AUC) of 0.822 (cutoff value: 1.722, sensitivity: 95.8%, specificity: 70.0%, 95% CI: 0.718 - 0.899). Conclusion: The degree of PTBE was found to be a valuable index for the differential diagnosis of LGGs from HGGs. It has a significant difference between IDH1 wild and mutation status, furthermore, it was positively correlated with the age and Ki-67 level.

scholarly journals Peritumoral brain edema in intracranial meningiomas

2010 ◽  
Vol 68 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Nelson de Azambuja Pereira-Filho ◽  
Fabiano Pasqualotto Soares ◽  
Ivan de Mello Chemale ◽  
Ligia Maria Barbosa Coutinho
Keyword(s):  
Brain Edema ◽  
Pathophysiological Mechanism ◽  
Histological Subtype ◽  
Porto Alegre ◽  
Olfactory Groove ◽  
Intracranial Meningiomas ◽  
Peritumoral Brain Edema

Occurrence of peritumoral brain edema (PBE) in meningiomas has been associated with several factors in recent years, although its pathophysiological mechanism has not yet been fully elucidated. The aim of this study was to analyze the correlation between the presence / degree of PBE and factors such as gender, age, size and histological subtype of tumor. We analyzed the MRI images of 74 patients operated on Hospital Beneficência Portuguesa de Porto Alegre for the presence / degree of PBE and data was statistically correlated with the parameters of the patient. PBE was present in 70.1% of patients. Tumors with higher volume had more PBE. Tumors of the olfactory groove showed more PBE than sphenoid wing and parassagittal tumors. Transitional subtype showed more PBE than fibroblastic and meningothelial subtypes.

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