Predictive value of brain edema in preoperative computerized tomography scanning on the recurrence of meningioma

Available online 28 July 2012

Peer review under responsibility of Alexandria University Faculty of Medicine.

Abstract

Introduction

Meningioma is a common benign intracranial tumor. The most common histological subtypes are the transitional and mesothelial subtypes. It can be cured by adequate excision, which is mostly measured by the Simpson grading system. Meningioma can have a peritumoral edema seen in the preoperative computerized tomography as well as in magnetic resonance imaging. It is caused by the release of vasogenic factors that causes leak of fluid from the blood vessels into the brain parenchyma. Recurrence of meningioma has been linked to the presence of preoperative peritumoral brain edema.

Aim

The aim of this study is to predict the possibility of meningioma recurrence based on the extent of brain edema in the preoperative computerized scanning of the brain.

Methods

Twenty five patients with supratentorial meningioma were retrospectively studied for the relationship between preoperative peritumoral brain edema as measured by the brain edema index and the recurrence of meningioma.

Results

The age of the patients ranged from 26 to 69 years. Males and females had almost equal percentages. Most of the cases recurred within a period from 3 years to less than 6 years; while the least recurrence occurred within one year of the surgery. Most of the cases of recurrent meningioma had high brain edema index. The higher the brain edema index, the less average years required for recurrence. The higher the preoperative brain edema index, the higher the possibility of postoperative complications. Tumors at a maximum diameter of three to less than six cm represented the majority of cases. Peritumoral brain edema was present in all cases in sphenoid ridge and parasagittal site.

Conclusion

Preoperative brain edema as measured by brain edema index on the preoperative brain computerized tomography scan had an important impact on the postoperative complication rate as well as on the incidence of tumor recurrence.

Keywords:

• Meningioma
• Edema
• Edema index

Notes

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 28 July 2012