Factors Influencing the Outcome of Surgical Intervention for Parasagittal Meningioma

Abstract

Aim: to analyze the factors that influenced the clinical outcome of patients with surgically-treated parasagittal meningiomas. Patients and Methods: a prospective study between 2011 through 2013 was conducted on 20 patients who were surgically treated from the diagnosis of parasagittal meningiomas. Thirteen (65%) were females and seven (35%) were males; age ranged from 14 to 65 years old (mean, 53.8±11.6). Follow-up ranged from 7 to 14 months (mean, 9.54±3.83). Lesions at the middle third of the Superior Sagittal Sinus (SSS) were represented in 11 patients, anterior third lesions (6 patients), then posterior third lesions (3 patients). All the patients were assessed by Computed tomography (CT) and magnetic Resonance imaging (MRI) brain, seven cases with Magnetic Resonance Venography (MRV) examination. Most of patients with anterior third lesions underwent total tumor removal and sinus resection safely. Patients with middle or posterior third lesions had total excision of all extrasinusal tumors and coagulation of the dural attachments. Analysis of the patient outcome was done using Karnofsky performance scale. Results: Tumor removal was grade I (according to Simpson’s grading system) in 20% of cases, grade II in 60% of cases, grade III in 10% of cases, and grade IV in the remaining 10% of cases. Total and subtotal tumor resection was achieved in 70% and 20% respectively. Surgery related mortality occurred in 2 cases, and recurrence occurred in one case. Conclusions: conservative surgery for meningiomas that are infiltrating but not obliterating the superior sagittal sinus may be considered adequate for treating these patients.