Complications after resection of parasagittal and superior sagittal sinus meningiomas.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Ivo Peto, Elliot Pressman, Keaton Piper, Gabriel Flores-Milan, Casey A Ryan, Gavin Lockard, Jonah Gordon, Adam Alayli, Harry van Loveren, Siviero Agazzi
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引用次数: 0

Abstract

Parasagittal meningiomas (PSM) represent one of the most frequently encountered intracranial meningiomas and pose unique challenges given their intimate relationship with parasagittal bridging veins and superior sagittal sinus (SSS). Compromise of venous drainage during resection might be a source of significant postoperative complications including catastrophic intraparenchymal hemorrhage. Objective of this study was to identify postoperative complications and associated factors predisposing to their development. A retrospective review of histologically confirmed parasagittal meningiomas (Sindou grade 1-6) resected between 2011 and 2020 was performed. A total of 62 patients (35 females (56.45%); mean age 55.72) years were included. The mean follow-up was 40.84 months. Forty-two patients (67.74%) were treatment naïve. Complete SSS occlusion was noted in 23 (37.1%). WHO grade 1 tumor was diagnosed in 32 (51.61%), WHO 2 in 23 (37.1%) and WHO 3 in 7 cases (11.29%). The SSS was resected in 24 (38.71%) patients. Intraparenchymal hemorrhage (ICH) was noted after 8 (12.90%) surgeries. Prior surgery (p = 0.006, OR = 22.1; 95% CI = 2.48-196.5) and higher tumor grade (OR = 4.64, 95% CI = 1.45-14.79, p = 0.01) were independently associated with greater risk of ICH. Resection of the SSS was not associated with postoperative ICH (p = 0.1388). A procedure-related mortality was noted in 2 patients (3.2%). Long term postoperative headaches were reported in 14 (22.58%) patients, associated with the resection of the SSS (p = 0.0003). Four (6.56%) patients had a CSF diversion procedure noted at the last follow up, correlated with ICH (p = 0.0124). History of prior surgery and higher WHO grade seem to be correlated with a significantly elevated risk of hemorrhage. Increased intracranial pressure, requiring CSF diversion is relatively infrequent occurring only in 6% patients, however awareness is important as prevention of its sequela is straightforward, preventing debilitating morbidity.

副矢状面脑膜瘤(PSM)是颅内最常见的脑膜瘤之一,由于其与副矢状面桥静脉和上矢状窦(SSS)的密切关系,提出了独特的挑战。在切除过程中静脉引流的妥协可能是一个重要的术后并发症的来源,包括灾难性的肺实质出血。本研究的目的是确定术后并发症及其发展的相关因素。回顾性回顾了2011年至2020年间切除的组织学证实的矢状旁脑膜瘤(Sindou 1-6级)。共62例,其中女性35例(56.45%);平均年龄55.72岁。平均随访40.84个月。42例(67.74%)患者接受治疗naïve。23例(37.1%)出现SSS完全闭塞。WHO 1级32例(51.61%),WHO 2级23例(37.1%),WHO 3级7例(11.29%)。24例(38.71%)患者切除SSS。术后8例(12.90%)发生肝实质出血。既往手术(p = 0.006, OR = 22.1;95% CI = 2.48 ~ 196.5)和较高的肿瘤分级(OR = 4.64, 95% CI = 1.45 ~ 14.79, p = 0.01)与脑出血风险增加独立相关。切除SSS与术后ICH无关(p = 0.1388)。2例患者(3.2%)出现手术相关死亡率。术后长期头痛患者14例(22.58%),与SSS切除术相关(p = 0.0003)。4例(6.56%)患者在最后随访时进行了脑脊液分流手术,与脑出血相关(p = 0.0124)。既往手术史和较高的WHO分级似乎与出血风险显著升高相关。颅内压升高,需要脑脊液分流的情况相对少见,仅在6%的患者中发生,然而,意识到这一点很重要,因为预防其后遗症很简单,可以预防使人衰弱的发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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