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

Teske, Nico ; Teske, Nina C.; Greve, Tobias; Karschnia, Philipp ; Kirchleitner, Sabrina V.; Harter, Patrick N.; Forbrig, Robert ; Tonn, Joerg-Christian; Schichor, Christian und Biczok, Annamaria (6. April 2024): Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3. In: Acta Neurochirurgica, Bd. 166, 170

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 cm3 (IR: 0–54 cm3). 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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Klinikum der LMU München > Neurochirurgische Klinik und Poliklinik
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0942-0940
• Sprache: Englisch