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Predictive Factors of Postoperative Peritumoral Brain Edema after Meningioma Resection: A Prospective Study

Ranjeet Kadamm, , Surendra Jain1 , Suresh Kumawat2 , Ranjeet Ravan Kadam3 , Ugan Singh Meena4 , Ashok Gupta5 , Ina Bahl6

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International Journal of Neurology and Neurosurgery 16 (3-4 ):p 51-59, July-December 2024. | DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.163424.2

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Surendra Jain, Suresh Kumawat, Ranjeet Ravan Kadam et al., Predictive Factors of Postoperative Peritumoral Brain Edema after Meningioma Resection: A Prospective Study. International Journal of Neurology and Neurosurgery. 2024;16(3-4):51-59.
 

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Abstract

Background: Postoperative peritumoral brain edema (PTBE) significantly impacts the clinical outcomes of patients undergoing meningioma resection.Objective: This study aimed to identify predictive factors of PTBE by examining various demographic, clinical, and surgical variables. Methods: A Prospective analysis was conducted on 50 patients who underwent meningioma resection. Data collected included age, sex, chief complaints, duration of symptoms, presence of preoperative seizures, tumor characteristics (location, origin, shape, MRI T2 intensity, maximum diameter, volume), edema volume, edema index, midline shift, and preoperative treatments (mannitol, steroids, anti-epileptic drugs). Surgical details such as tumor consistency, Simpson grade of resection, sinus violation, operative time, intraoperative blood loss, and histopathological features including WHO grade and prominent nucleoli were also analyzed. Postoperative edema was assessed on day 7 after surgery. Results: Preliminary analysis indicated that 21 patients (42%) diagnosed having postoperative PTBE. Preoperative seizures, Sinus violation during surgery, Prominent nucleoli, mixed tumor consistency (soft+ firm) were the independent risk factors for postoperative PTBE,whereas Preoperative Mannitol use and Steroid usewere independent protective factors for postoperative PTBE. It was also found that sphenoid wing meningioma resection was associated with significant postoperative PTBE as compared to all other tumour locations. Tumor size, Tumor shape, Tumor MRI T2 intensity, midline shift, surgical simpsons grade and histopathological grade did not significantly increase complication rate. Detailed statistical analysis is ongoing to further elucidate these relationships. Conclusion: This study identifies several predictive factors of PTBE following meningioma resection. Use of Mannitol and Steroid in preoperative period is protective in developing postoperative PTBE. Factors like preoperative seizures, sinus violation, prominent nucleoli, mixed tumor consistency should warrant surgeon’s attention and needs comprehensive perioperative management to mitigate the risks. Further studies with larger sample sizes are necessary to validate these findings

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Surendra Jain, Suresh Kumawat, Ranjeet Ravan Kadam et al., Predictive Factors of Postoperative Peritumoral Brain Edema after Meningioma Resection: A Prospective Study. International Journal of Neurology and Neurosurgery. 2024;16(3-4):51-59.
 

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DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.163424.2

Keywords

Meningioma ResectionPeritumoral Brain EdemaPredictive Factors

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