Surgical management of falcine meningiomas / Mohammed Atef Abdelghafar Azab ; Supervised Hazem Abuelnasr , Ahmed Elsaid , Mohammed Adel Ghoneim

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

The purpose of this study was to review the characteristics of fal- cine meningioma retrospectively and to identify the parameters associat- ed with tumor recurrence and postoperative complications. The analysis included; age, sex, extent of resection, and radiologic and pathologic findings. Falcine meningiomas were classified by location as anterior, middle, or posterior. In this study, we operated on 20 patients with falcine meningiommas with mean age 50 years old, 8 males and 12 females. Headache was the main complaint. The lesion was related to the anterior third in 12 patients and to the middle third in 8 patients. The tumor was totally excised in 19 patients and sub totally removed in one patient. Among those patients 16 showed improved outcome, 4 patients developed venous infarctions. There was a reported mortality case due to postoperative brain swelling. No recurrent cases were reported in this study over a follow up period of 9 months. With regards to prognosis, the extent of surgical resection was found to be related to tumor recurrence. However, tumor size, pathological subtype were not found to be related to tumor recurrence. Subtotal resection is associated with high rates of recurrence, while total resection is associated with low rates of recurrence. On the other hand, most of our complications could be avoided with subtotal resection and less aggressive treatment. Aggressive treatment and trials to resect the tumor totally is associated with high risk of venous injury, postoperative edema, infarction and mortality

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