Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3.

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: Austria NLM ID: 0151000 Publication Model: Electronic Cited Medium: Internet ISSN: 0942-0940 (Electronic) Linking ISSN: 00016268 NLM ISO Abbreviation: Acta Neurochir (Wien) Subsets: MEDLINE
    • Publication Information:
      Original Publication: Wien, Springer.
    • Subject Terms:
      Meningioma*/complications ; Meningioma*/surgery ; Meningioma*/pathology ; Meningeal Neoplasms*/complications ; Meningeal Neoplasms*/surgery ; Meningeal Neoplasms*/pathology ; Brain Edema*/etiology ; Brain Edema*/surgery; Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Quality of Life ; Seizures/etiology ; Seizures/epidemiology ; Risk Factors ; Edema ; World Health Organization
    • Abstract:
      Background: Patients with intracranial meningiomas frequently suffer from tumor-related seizures prior to resection, impacting patients' quality of life. We aimed to elaborate on incidence and predictors for seizures in a patient cohort with meningiomas WHO grade 2 and 3.
      Methods: We retrospectively searched for patients with meningioma WHO grade 2 and 3 according to the 2021 WHO classification undergoing tumor resection. Clinical, histopathological and imaging findings were collected and correlated with preoperative seizure development. Tumor and edema volumes were quantified.
      Results: Ninety-five patients with a mean age of 59.5 ± 16.0 years were included. Most tumors (86/95, 90.5%) were classified as atypical meningioma WHO grade 2. Nine of 95 tumors (9.5%) corresponded to anaplastic meningiomas WHO grade 3, including six patients harboring TERT promoter mutations. Meningiomas were most frequently located at the convexity in 38/95 patients (40.0%). Twenty-eight of 95 patients (29.5%) experienced preoperative seizures. Peritumoral edema was detected in 62/95 patients (65.3%) with a median volume of 9 cm 3 (IR: 0-54 cm 3 ). Presence of peritumoral edema but not age, tumor localization, TERT promoter mutation, brain invasion or WHO grading was associated with incidence of preoperative seizures, as confirmed in multivariate analysis (OR: 6.61, 95% CI: 1.18, 58.12, p = *0.049). Postoperative freedom of seizures was achieved in 91/95 patients (95.8%).
      Conclusions: Preoperative seizures were frequently encountered in about every third patient with meningioma WHO grade 2 or 3. Patients presenting with peritumoral edema on preoperative imaging are at particular risk for developing tumor-related seizures. Tumor resection was highly effective in achieving seizure freedom.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Anaplastic; Atypical; Edema; Epilepsy; Meningioma; Seizure
    • Publication Date:
      Date Created: 20240406 Date Completed: 20240408 Latest Revision: 20240409
    • Publication Date:
      20240409
    • Accession Number:
      PMC10998776
    • Accession Number:
      10.1007/s00701-024-06057-3
    • Accession Number:
      38581569