Predictive Factors of Postoperative Peritumoral Brain Edema after Meningioma Resection

2021 ◽  
Vol 69 (6) ◽  
pp. 1682
Author(s):  
Jian Gong ◽  
Liang-Ming Li ◽  
Wen-Jian Zheng ◽  
Ying-Zhi Chen ◽  
Zi-Hui Hu ◽  
...  
Keyword(s):  
Brain Edema ◽  
Predictive Factors ◽  
Peritumoral Brain Edema

scholarly journals Predictive factors for the development of peritumoral brain edema after LINAC-based radiation treatment in patients with intracranial meningioma

2019 ◽  
Author(s):  
Ryang-Hun Lee ◽  
Jae Min Kim ◽  
Jin Hwan Cheong ◽  
Je Il Ryu ◽  
Young Soo Kim ◽  
...  
Keyword(s):  
Brain Edema ◽  
Predictive Factors ◽  
Tumor Volume ◽  
Radiation Treatment ◽  
Characteristic Curve ◽  
Critical Role ◽  
Hazard Ratio ◽  
Intracranial Meningioma ◽  
Large Tumor ◽  
Peritumoral Brain Edema

AbstractBackground and purposeDisruption of the tumor-brain barrier in meningioma plays a critical role in the development of peritumoral brain edema (PTBE). We hypothesized that osteoporotic conditions may be associated with PTBE occurrence after radiation in patients with intracranial meningioma.MethodsWe measured Hounsfield units (HU) of the frontal skull on simulation brain CT in patients who underwent linear accelerator (LINAC)-based radiation treatment for intracranial meningioma. Receiver operating characteristic curve analysis was performed to determine the optimal cut-off values for several predictive factors. The cumulative hazard for PTBE was estimated and classified according to these factors. Hazard ratios were then estimated to identify independent predictive factors associated with the development of PTBE after radiation in intracranial meningioma patients.ResultsA total of 83 intracranial meningiomas in 76 patients who received LINAC-based radiation treatment in our hospital over an approximate 5-year period were included for the study. We found mean frontal skull HU ≤630.625 and gross tumor volume >7.194 cc to be independent predictors of PTBE after radiation treatment in patients with meningioma (hazard ratio, 8.38; P=0.021; hazard ratio, 5.78; P=0.034, respectively). In addition, patients who were ≥65 years showed a marginally significant association with PTBE.ConclusionsOur study suggests that possible osteoporotic conditions, large tumor volume, and older age may be associated with PTBE occurrence after LINAC-based radiation treatment for intracranial meningioma. In the future we anticipate that these findings may enhance the understanding of the underlying mechanisms of PTBE after radiation in meningioma patients.

scholarly journals The importance of pial blood supply to the development of peritumoral brain edema in meningiomas

1997 ◽  
Vol 2 (4) ◽  
pp. E6 ◽  
Author(s):  
Michael Bitzer ◽  
Lars Wöckel ◽  
Andreas R. Luft ◽  
Ajay K. Wakhloo ◽  
Dirk Petersen ◽  
...  
Keyword(s):  
Brain Edema ◽  
Blood Supply ◽  
Tumor Size ◽  
Tumor Volume ◽  
Volume Ratio ◽  
Total Tumor Volume ◽  
Pial Vessels ◽  
Peritumoral Brain Edema ◽  
Tumor Region ◽  
The Mean

The authors studied the pial and dural blood supplies in 74 intracranial meningiomas and quantified their associated peritumoral brain edema (PTBE). The extent and localization of pial blush in relation to the total tumor volume were determined angiographically. The amount of edema and tumor size were calculated using computerized tomography. The edema-tumor volume ratio was defined as Edema Index (EI). There were 49 meningiomas with PTBE; of those tumors, 46 were supplied by pial vessels, and three were supplied exclusively by dural vessels. Tumors without PTBE showed no pial blush. The mean EI in meningiomas with pial blush was significantly larger (EI = 3.0) than in meningiomas without pial supply (EI = 1.1; p < 0.0001). Meningiomas in which 10% of the whole tumor volume was supplied by pial vessels had only a small mean EI of 2.2, whereas tumors with pial blood supply greater than or equal to 20% had a mean EI of 3.3 (p < 0.026). In 69.9% of cases with pial blood supply, major portions of the edema were located adjacent to the tumor region supplied by pial vessels. Edema index differences among tumors of different subgroups, as defined by size or histology, were significantly related to the pial supply in each subset. Thus, pial blood supply may be causative for the development of PTBE in meningiomas.

scholarly journals Peritumoral brain edema associated with meningioma

Cancer ◽  
1999 ◽  
Vol 85 (4) ◽  
pp. 936-944 ◽  
Author(s):  
Hiroyuki Yoshioka ◽  
Seiji Hama ◽  
Eiji Taniguchi ◽  
Kazuhiko Sugiyama ◽  
Kazunori Arita ◽  
...  
Keyword(s):  
Brain Edema ◽  
Peritumoral Brain Edema

Peritumoral brain edema in angiomatous supratentorial meningiomas: an investigation of the vascular endothelial growth factor A pathway

Apmis ◽  
2013 ◽  
Vol 121 (11) ◽  
pp. 1025-1036 ◽  
Author(s):  
Damoun Nassehi ◽  
Lars P. Sørensen ◽  
Henrik Dyrbye ◽  
Carsten Thomsen ◽  
Marianne Juhler ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Brain Edema ◽  
Vascular Endothelial ◽  
Peritumoral Brain Edema ◽  
Endothelial Growth Factor

Role of hydrodynamic processes in the pathogenesis of peritumoral brain edema in meningiomas

2000 ◽  
Vol 93 (4) ◽  
pp. 594-604 ◽  
Author(s):  
Michael Bitzer ◽  
Thomas Nägele ◽  
Beverly Geist-Barth ◽  
Uwe Klose ◽  
Eckardt Grönewäller ◽  
...  
Keyword(s):  
Contrast Agent ◽  
Brain Edema ◽  
Brain Tissue ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
Extracellular Contrast Agent ◽  
Peritumoral Brain Edema ◽  
Hydrodynamic Processes ◽  
Fine Print

Object. In a prospective study, 28 patients with 32 intracranial meningiomas were examined to determine the role of hydrodynamic interaction between tumor and surrounding brain tissue in the pathogenesis of peritumoral brain edema.Methods. Gadolinium—diethylenetriamine pentaacetic acid (Gd-DPTA), an extracellular contrast agent used for routine clinical imaging, remains strictly extracellular without crossing an intact blood—brain barrier. Therefore, it is well suited for investigations of hydrodynamic extracellular mechanisms in the development of brain edema. Spin-echo T1-weighted magnetic resonance images were acquired before and after intravenous administration of 0.2 mmol/kg Gd-DPTA. Additional T1-weighted imaging was performed 0.6, 3.5, and 6.5 hours later. No significant Gd-DPTA diffused from tumor into peritumoral brain tissue in 12 meningiomas without surrounding brain edema. In contrast, in 17 of 20 meningiomas with surrounding edema, contrast agent in peritumoral brain tissue was detectable after 3.5 hours and 6.5 hours. In three of 20 meningiomas with minimum surrounding edema (< 5 cm3), contrast agent effusion was absent. After 3.5 hours and 6.5 hours strong correlations of edema volume and the maximum distance of contrast spread from the tumor margin into adjacent brain parenchyma (r = 0.84 and r = 0.87, respectively, p < 0.0001) indicated faster effusion in larger areas of edema.Conclusions. The results of this study show that significant contrast agent effusion from the extracellular space of the tumor into the interstitium of the peritumoral brain tissue is only found in meningiomas with surrounding edema. This supports the hypothesis that hydrodynamic processes play an essential role in the pathogenesis of peritumoral brain edema in meningiomas.

scholarly journals High Delta-Like Ligand 4 (DLL4) Is Correlated With Peritumoral Brain Edema and Predicts Poor Prognosis in Primary Glioblastoma

Medicine ◽  
2014 ◽  
Vol 93 (8) ◽  
pp. e57 ◽  
Author(s):  
Xian-xin Qiu ◽  
Long Chen ◽  
Chen-hong Wang ◽  
Zhi-xiong Lin ◽  
Chang-fu Zhou ◽  
...  
Keyword(s):  
Brain Edema ◽  
Poor Prognosis ◽  
Primary Glioblastoma ◽  
Peritumoral Brain Edema

Prostaglandins F2α and E2 as Possible Mediators of Peritumoral Brain Edema

1988 ◽  
pp. 243-249 ◽  
Author(s):  
J. Anagnostopoulos-Schleep ◽  
W. Schlegel ◽  
K. H. Krähling ◽  
H.-J. König
Keyword(s):  
Brain Edema ◽  
Peritumoral Brain Edema

Peritumoral Brain Edema and Cortical Damage by Meningioma

1994 ◽  
pp. 369-372 ◽  
Author(s):  
Mitsunobu Ide ◽  
M. Jimbo ◽  
O. Kubo ◽  
M. Yamamoto ◽  
E. Takeyama ◽  
...  
Keyword(s):  
Brain Edema ◽  
Cortical Damage ◽  
Peritumoral Brain Edema

scholarly journals P.101 Conservative management of meningiomas with a moderate to high peritumoral brain edema index: a single-institution report

2019 ◽  
Vol 46 (s1) ◽  
pp. S40
Author(s):  
H Yan ◽  
B Karmur ◽  
D Jeong ◽  
M Bernstein
Keyword(s):  
Brain Edema ◽  
Medical Management ◽  
Case Series ◽  
Imaging Features ◽  
Retrospective Case ◽  
Patient Morbidity ◽  
Large Spread ◽  
Peritumoral Brain Edema ◽  
Mri Scans

Background: Meningiomas are the most commonly occurring benign intracranial tumors. When presenting with peritumoral brain edema (PTBE), surgical treatment can lead to patient morbidity. This retrospective case series aims to describe the conservative medical management of moderate to large meningiomas with large PTBE. Methods: Patients with suspected meningiomas greater than 2.0cm and edema index greater than 2.0 were identified by screening 3345 MRI scans between 2012-2017. Imaging analysis included MR imaging features of suspected meningiomas and clinical data was gathered from the electronic patient record (patient age, sex, patient symptoms, follow-up duration, and follow-up symptoms). Results: We report on 31 patients who received conservative medical management. Presenting complaints included headache, seizure, weakness; many presented asymptomatically. The average follow-up time was 3.96 years. At the final follow-up appointment, 19 (61%) patients were asymptomatic. Among symptomatic patients, seizures were the most common complaint. There was no mortality reported in our cohort and the average tumor progression was 7.04cm3/year. Conclusions: In this retrospective report of meningioma patients with high edema index, we found that most patients remained asymptomatic or had stable symptoms after at least 1-yr follow up after medical treatment. This study provides insight around the surgical decision-making for meningiomas with large spread of edema.

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