A study of retrospective analysis of the outcome of parasagittal meningioma

Authors

  • A. Pazhaniyandi Department of Neurosurgery, Kanyakumari Government Medical College, Tamil Nadu, India
  • R. R. Ramkumar Department of Neurosurgery, Kanyakumari Government Medical College, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20201847

Keywords:

DC, Gross total resection, Parasagittal meningioma, Recurrence, STR

Abstract

Background: Meningioma is a common benign tumours treated by neurosurgeons. They develop from arachnoid cap cells within the thin spider web-like membrane covering the brain and spinal cord. The arachnoid is one of the three protective layers of the central nervous system collectively known as the meninges surrounding the brain and spinal cord. The aim of our study is to analyze the outcome of parasagittal meningioma.

Methods: The details of the patients diagnosed with parasagittal meningioma and operated upon during the study period of 2009-2013 were retrospectively collected from the medical records kept in the department of neurosurgery and different study parameters were documented for analysis.

Results: Out of the total 40 patients with meningioma 15 (37.5%) patients had parasagittal meningioma in anterior 1/3rd of sagittal sinus, 21 (52.5%) patients had parasagittal meningioma in middle 1/3rd of sagittal sinus and 4 (10%) patients had parasagittal meningioma in posterior 1/3rd of the sagittal sinus and 28 (70%) patients  are treated by gross total resection (GTR), 7 (17.5%) patients were treated by subtotal resection (STR) and 5 (12.5%) patients were treated by dendritic cell (DC) and postoperatively 22 patients (55%) did not develop any complications. Weakness develops for 12 patients (30%), followed by recurrence in 3 patients (7.5%) and 3 patients (7.5%) died.

Conclusions: Conservative resection of the tumour with residual lesion within the sagittal sinus followed by adjuvant treatment with modalities like radiotherapy, chemotherapy or targeted therapy for the residual lesion is an accepted mode of treatment.

References

Al-Mefty O. Operative Atlas of Meningiomas. Philadelphia, PA: Lippincott-Raven; 1998: 209-286.

Bikmaz K, Mrak R, Al-Mefty O. Management of bone-invasive, hyperostotic sphenoid wing meningiomas. J Neurosurg. 2007;107:905-12.

Cushing H, Eisenhardt L. Meningiomas. Their Classification, Regional Behavior, Life History, and Surgical End Results. Springfield, IL: Charles C Thomas; 1938: 283-297.

Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol. 2010;99:307-14.

Kurland LT, Schoenberg BS, Annegers JF, Okazaki H, Molgaard CA. The incidence of primary intracranial neoplasms in Rochester, Minnesota, 1935–1977. Ann NY Acad Sci. 1982;381:6-16.

Colli BO, Carlotti CG Jr, Assirati JA Jr, Dos Santos MB, Neder L, Dos Santos AC. Parasagittal meningiomas: follow-up review. Surg Neurol. 2006:66:20-7.

Awadalla AM, Khan A, Zaiton F, Abdelbary E. Management of High Convexity, Parasagittal and Falcine Meningiomas. Egyptian J Neurosurg. 2014;29(2):25-36.

DiMeco F, Li KW, Casali C, Ciceri E, Giombini S, Filippini G, et al. Meningiomas invading the superior sagittal sinus: surgical experience in 108 cases. Neurosurg. 2004:55(6);1263-72.

Czepko R, Pietraszko W, Turski T, Kamieniecka B, Kwinta B, Adamek D. Direct surgical outcome of meningiomas obliterating the superior sagittal sinus. Prezegl Lek. 2006:63(8);610-5.

Skudas G, Tamasauskas A. Prognosis of the surgical treatment of parasagittal meningioma. Medicina (Kaunas). 2002:38(11):1089-96.

Bi N, Xu RX, Liu RY, Wu CM, Wang J, Chen WD, et al. Microsurgical treatment for parasagittal meningioma in the central gyrus region. Oncol Letters. 2013;6(3):781-4.

Mathiesen T, Pettersson-Segerlind J, Kihlström L, Ulfarsson E. Meningiomas engaging major venous sinuses. World Neurosurg. 2014;(1);116-24.

Pettersson SJ, Orrego A, Lönn S, Mathiesen T. Long-term 25-year follow-up of surgically treated parasagittal meningiomas. World Neurosurg. 2011;76(6);564-71.

Downloads

Published

2020-04-23

Issue

Section

Original Research Articles