A study of challenges faced in the management of giant meningiomas
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 366-373
AbstractMeningiomas are most common tumours of human population, most cases being incidentalomas. Giant meningiomas (>50mm) demand thorough evaluation and planning for management to avoid untoward events. This study was mainly undertaken to understand technical factors and challenges faced in dealing with giant meningiomas.
Methods: The data of the 45 giant meningioma cases, diagnosed and operated on during the study period, was collected from the preoperative, intraoperative and postoperative periods. The data of neurological examination was also collected retrospectively. The data was compiled and analyzed.
Results: Majority of the patients were female and middle aged. Seizures was the most common presentation. The predominant location of the lesion was in parasagittal region and maximum size was upto 90 mm. Neuronavigation was used for precision of craniotomy. Venogram was not routinely performed even in tumors having sinus involvement. More than half of the cases had Simpson grade 1 excision, almost one third had grade two excision. Most of the higher grade excisions were seen in tumors abutting major venous sinuses. Posterior fossa lesions were found to have relatively more complications. Two patients had morbidity and one patient had mortality in this study.
Conclusions: A good pre-operative planning including temporary CSF drainage if required, is essential for good results. The size of the lesion does not necessarily seem to influence the outcome.
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