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J Neurol Surg B Skull Base 2019; 80(01): 059-066
DOI: 10.1055/s-0038-1667066
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Risk of Developing Postoperative Deficits Based on Tumor Location after Surgical Resection of an Intracranial Meningioma

Jeff S. Ehresman
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Tomas Garzon-Muvdi
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Davis Rogers
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Michael Lim
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Gary L. Gallia
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Jon Weingart
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Henry Brem
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Chetan Bettegowda
1   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Kaisorn L. Chaichana
2   Department of Neurosurgery, Mayo Clinic Florida, Jacksonville, Florida, United States
› Author Affiliations
Further Information

Publication History

29 January 2018

06 June 2018

Publication Date:
17 July 2018 (online)

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Abstract

Object Meningiomas occur in various intracranial locations. Each location is associated with a unique set of surgical nuances and risk profiles. The incidence and risk factors that predispose patients to certain deficits based on tumor locations are unclear. This study aimed to determine which preoperative factors increase the risk of patients having new deficits after surgery based on tumor location for patients undergoing intracranial meningioma surgery.

Methods Adult patients who underwent primary, nonbiopsy resection of a meningioma at a tertiary care institution between 2007 and 2015 were retrospectively reviewed. Stepwise multivariate logistic regression analyses were used to identify associations with postoperative deficits based on tumor location.

Results Postoperatively, from the 761 included patients, there were 39 motor deficits (5.1%), 23 vision deficits (3.0%), 19 language deficits (2.5%), 27 seizures (3.5%), and 26 cognitive deficits (3.4%). The factors independently associated with any postoperative deficits were preoperative radiation (hazard ratio [HR] [95% confidence interval, CI] 3.000 [1.346–6.338], p = 0.008), cerebellopontine angle tumors (HR [95% CI] 2.126 [1.094–3.947], p = 0.03), Simpson grade 4 resections (HR [95% CI] 2.000 [1.271–3.127], p = 0.003), preoperative motor deficits (HR [95% CI] 1.738 [1.005–2.923], p = 0.048), preoperative cognitive deficits (HR [95% CI] 2.033 [1.144–3.504], p = 0.02), and perioperative pulmonary embolisms (HR [95% CI] 11.741 [2.803–59.314], p = 0.0009).

Conclusion Consideration of the factors associated with postoperative deficits in this study may help guide treatment strategies for patients with meningiomas.

Keywords

complications - meningioma - postoperative deficits - risk factors - surgical resection - tumor location
 

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