Anatomical basis of intracranial meningiomas referred for preoperative embolisation: A retrospective chart review

Abstract

IntroductionMeningiomas are described as intracranial, extra-axial tumours arising from the arachnoid cap cells of the meninges. Due to the vast expanse of the meninges, the clinical presentation of meningiomas may vary. Treatment of this pathology involves surgical resection of the tumour. Preoperative tumour embolisation has proven to reduce blood loss during resection, however, misidentification of the vascular territory may lead to various post-operative complications such as cranial nerve palsies. MethodsThe present study aimed to investigate the anatomy of intracranial meningiomas, referred for preoperative embolisation at a regional hospital. Patient demographics, histological reports, Magnetic Resonance Images and Digital Subtraction Angiography's of 98 patients were utilised to analyse the study's objectives. ResultsWe report a high incidence of meningiomas in the female (67.3%; 81.3 cm3) population with a smaller tumour volume in relation to males (32.7%; 102 cm3). The Grade I meningioma (70.4%) was the most common with the meningothelial (48%) subtype being predominant. Regarding the blood supply, the internal carotid arteries were noted to be the primary feeders in the skull base region whilst the left external carotid artery was noted to be a primary feeder in the supratentorial region. ConclusionThe results from this investigation provided insight into the variable anatomy of intracranial meningiomas within a select South African population. Key outcomes from this study support the female predisposition for meningiomas along with the high incidences of meningiomas of the WHO Grade I and in the supratentorial region. Further research should be carried out as a comparative study in patients that were not referred for preoperative embolisation.