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KMID : 0942820100090010008
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Journal of Korean Brain Tumor Society
2010 Volume.9 No. 1 p.8 ~ p.13
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Surgical Strategies for Large Intracranial Meningiomas
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Ahn Sang-Soak
Song Young-Jin
Kim Ki-Uk
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Abstract
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Objective: Surgical management of large intracranial meningiomas is extremely challenging depending on factors such as their size, location, extent of hyperostosis, and cerebral edema. In this retrospective study, we developed a new clinicalradiological scoring system(CRSS) to predict the extent of resection of large intracranial meningiomas.
Materials and Methods: From January 2004 to December 2008, we retrospectively analyzed 20 patients admitted to our neurosurgical department, who had been surgically treated for large intracranial meningiomas(maximum diameter, ≥5
cm). The tumor size, location, presence of hyperostosis, degree of cerebral edema and angiographic embolization were
considered in our analysis. On the basis of these factors, a preoperative CRSS was proposed for all these patients.
Results: Simpson Grade 1 was achieved in 7 patients. Grade 2, in 5, and grade 4, in 8 in order to avoid surgical morbidity. We observed that there was considerable difficulty in achieving complete excision of the tumor(p=0.028) when the preoperative clinical-radiological score was≥5 with a maximum possible score of 8.
Conclusion: The CRSS was useful in predicting the degree of difficulty during surgical excision of large intracranial meningiomas.
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KEYWORD
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Intracranial meningioma, Scoring system, Surgery
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