Parasagittal meningiomas: surgical treatment outcomes

Authors

DOI:

https://doi.org/10.25305/unj.259324

Keywords:

parasagittal meningioma, parasagittal meningioma surgery, superior sagittal sinus, treatment outcomes, completeness, further growth, recurrences

Abstract

Purpose: to improve the outcomes of surgical treatment of parasagittal meningioma patients by implementing a differentiated approach to the choice of surgical intervention, given the preoperative assessment of patency of the superior sagittal sinus (SSS) and collateral venous circulation.

Materials and methods. Analysis of short-term and long-term outcomes of surgical treatment of 199 patients in the Department of Neurosurgery № 2, Mechnikov Dnipropetrovsk Regional Clinical Hospital was carried out. In the first follow-up period (2000 to 2012), the data were obtained retrospectively (95 cases). In the second follow-up period (2013 to 2021), the data were obtained prospectively (104 cases). The patients were assigned to the groups according to a differentiated approach (implemented in 2013) to the choice of surgical treatment tactics based on preoperative angiographic data (selective cerebral angiography and CT angiography).

Results. In the first follow-up period, the completeness of surgical resection according to Simpson Grading Scale was: type I, 23 (24.2%) cases; type II, 37 (38.9%) cases; type III, 13 (13.7%) cases; type IV, 22 23.2%) cases. 53.7% of patients had intraoperative or postoperative complications. Among patients with tumors of the middle third of the SSS, 21 (41.2%) had their neurological status improved postoperatively. Mortality rate was 4.2%. 14 (14.7%) patients had further parasagittal meningioma growth after its removal grade II–IV according to Simpson Scale.

In the second follow-up period, the completeness of surgical intervention according to Simpson Scale was: type I, 74 (71.2%) cases; type II, 26 (25%) cases; type III, 2 (1.9%) cases; type IV, 2 (1.9%) cases. 19.2% of patients had intraoperative or postoperative complications. Among the patients with tumors of the middle third of the SSS, 46 (79.3%) patients had postoperative improvement of neurological status. No lethal outcome was reported. 3 (2.9%) patients had further parasagittal meningioma growth after radical surgical removal according to Simpson grade II.

Conclusions. Adequate analysis of instrumental methods of brain study using cerebral vasculature study, application of neuronavigation station (with brain MRI and/or CT angiography data available) and new microsurgical techniques contributed to the completeness of surgery and minimally invasive removal of parasagittal meningioma with reduced intraoperative and postoperative complications, which affected the immediate and long-term treatment outcomes.

Author Biographies

Andrii H. Sirko, Dnipropetrovsk State Medical University; Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro

Department of Nervous Diseases and Neurosurgery; Center for Cerebral Neurosurgery

Vadym A. Perepelytsia, Dnipropetrovsk State Medical University; Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro

Department of Nervous Diseases and Neurosurgery; Endovascular Center

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Published

2022-09-29

How to Cite

Sirko, A. H., & Perepelytsia, V. A. (2022). Parasagittal meningiomas: surgical treatment outcomes. Ukrainian Neurosurgical Journal, 28(3), 33–42. https://doi.org/10.25305/unj.259324

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Section

Original articles