Management of Intracranial Meningioma

Abstract

Objective: The aim of this study is to evaluate different modalities of treatment of intracranial meningioma which admitted to neurosurgery department of Sohag University through two years. Methods: we operated upon 30 patients with the oldest was 70 years old and the youngest was 16 years old, with mean age of 49.23 years 21 females and 9 males, according to the complaint the most common was headache in 20 cases, followed by fits in 12 cases, then weakness in 6 cases, and mental and behavioral changes in 5 cases, and vision changes in 4cases. Results: The lesion was totally removed in 24 cases and subtotal in 6 cases. Among these 30 patients 22 patients improved, 7 patients remained the same, and one patient deteriorated. Among the 30 patients two patient complicated by CSF leak and 4 patients complicated by wound infection, and only two patients showed increased weakness, As for the pathology 7 cases with transitional meningiomas, 4 cases fibroblastic meningiomas, 2 cases with atypical meningiomas, 9 cases meningiothelial meningiomas, 5 cases psammomatus meningiomas, 3 cases mixed meningiomas. Conclusion: The use of both computerized tomography and magnetic resonance imaging was found to be mandatory and none of them can replace the other for proper and accurate diagnosis and visualization of these meningiomas preoperatively. The choice of surgical approach remains that of surgeon guided by tumor nature and many other factors. Although these approaches were found to be extremely satisfactory when properly selected, every effort should be done for applying the minimally invasive approaches as well as key-hole surgery whenever appropriately indicated and with the availability of their modern technical instrumentations and adjunctive image guidance.