Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3
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Published:2024-04-06
Issue:1
Volume:166
Page:
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ISSN:0942-0940
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Container-title:Acta Neurochirurgica
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language:en
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Short-container-title:Acta Neurochir
Author:
Teske NicoORCID, Teske Nina C., Greve Tobias, Karschnia Philipp, Kirchleitner Sabrina V., Harter Patrick N., Forbrig Robert, Tonn Joerg-Christian, Schichor Christian, Biczok Annamaria
Abstract
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.
Funder
Universitätsklinik München
Publisher
Springer Science and Business Media LLC
Reference29 articles.
1. Biczok A, Kraus T, Suchorska B, Terpolilli NA, Thorsteinsdottir J, Giese A, Tonn JC, Schichor C (2018) TERT promoter mutation is associated with worse prognosis in WHO grade II and III meningiomas. J Neurooncol 139:671–678. https://doi.org/10.1007/s11060-018-2912-7 2. Capper D, Stichel D, Sahm F, Jones DTW, Schrimpf D, Sill M, Schmid S, Hovestadt V, Reuss DE, Koelsche C, Reinhardt A, Wefers AK, Huang K, Sievers P, Ebrahimi A, Schöler A, Teichmann D, Koch A, Hänggi D, Unterberg A, Platten M, Wick W, Witt O, Milde T, Korshunov A, Pfister SM, von Deimling A (2018) Practical implementation of DNA methylation and copy-number-based CNS tumor diagnostics: the Heidelberg experience. Acta Neuropathol 136:181–210. https://doi.org/10.1007/s00401-018-1879-y 3. Chaichana KL, Pendleton C, Zaidi H, Olivi A, Weingart JD, Gallia GL, Lim M, Brem H, Quiñones-Hinojosa A (2013) Seizure control for patients undergoing meningioma surgery. World Neurosurg 79:515–524. https://doi.org/10.1016/j.wneu.2012.02.051 4. Chen WC, Magill ST, Englot DJ, Baal JD, Wagle S, Rick JW, McDermott MW (2017) Factors associated with pre- and postoperative seizures in 1033 patients undergoing supratentorial meningioma resection. Neurosurgery 81:297–306. https://doi.org/10.1093/neuros/nyx001 5. Dincer A, Jalal MI, Gupte TP, Vetsa S, Vasandani S, Yalcin K, Marianayagam N, Blondin N, Corbin Z, McGuone D, Fulbright RK, Erson-Omay Z, Günel M, Moliterno J (2023) The clinical and genomic features of seizures in meningiomas. Neurooncol Adv 5:i49–i57. https://doi.org/10.1093/noajnl/vdac110
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