The importance of pial blood supply to the development of peritumoral brain edema in meningiomas

Bitzer, Michael; Wöckel, Lars; Luft, Andreas R.; Wakhloo, Ajay K.; Petersen, Dirk; Opitz, H.; Sievert, Theo; Ernemann, Ulrike; Voigt, Karsten

doi:10.3171/jns.1997.87.3.0368

Cited by 90 publications

(38 citation statements)

References 35 publications

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“…The quantity and location of peritumoral edema was associated with induction of pial blood supply by meningiomas in a recent paper by Bitzer and colleagues. [4] The results of these studies suggest that meningiomas that are associated with peritumoral edema have higher indices of proliferative activity and produce more vasotrophic and vasoactive factors than those that are not.…”

Section: Discussionmentioning

confidence: 59%

Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning

Mantle¹,

Lach²,

Delgado³

et al. 1999

FOC

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Object The goal of this study was to determine whether the quantity of peritumoral brain edema displayed on computerized tomography (CT) scanning could be correlated with brain invasion and subsequent recurrence of meningiomas. Methods One hundred thirty-five patients who underwent resection of intracranial meningiomas at the Ottawa Civic Hospital were followed during the period 1980 to 1998. A complete resection was defined as one in which tumor, invaded bone, and involved dura were removed. Tumors were examined microscopically for evidence of brain invasion. The mean follow-up period was 9 years (± 4 years, standard deviation [SD]) and the mean time to recurrence was 5 years (± 4 years, SD). The authors used a simple grading system based on the average thickness (in centimeters) of edema seen on an axial CT slice showing the most tumor. Edema grade was linearly related to edema volume determined by digitizing the scans (r = 0.96; 29 cases). The chance of brain invasion increased by 20% for each centimeter of edema (rs = 1, p < 0.0001; 124 cases). The presence of brain invasion was predictive of recurrence after complete resection with an accuracy of 83%, a sensitivity of 89%, and a specificity of 82%. The chance of recurrence within 10 years after complete resection was given by the equation: percentage chance of recurrence = (centimeter of edema)3 X 0.7, which can be used to predict the chance of recurrence based on findings on CT scans (rs = 1.00, p < 0.0001; 86 patients). Statistical significance was confirmed using Kaplan-Meier and univariate and multivariate analyses. Completeness of resection was the most powerful predictor of recurrence (p < 0.00001, r = 0.6), followed by edema grade and brain invasion (both p = 0.02, r = 0.1). Patient age and gender and tumor location, size, and histological subtype were nonsignificant factors. Conclusions Brain invasion causes peritumoral edema. Invaded brain tissue is also the source of residual cells in cases of tumor recurrence after gross-total resection.

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Section: Discussionmentioning

confidence: 59%

Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning

Mantle¹,

Lach²,

Delgado³

et al. 1999

FOC

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“…Peritumoral edema develops strongly where the meningioma is attached to the surrounding brain tissue, the arachnoid is disrupted, and cerebral vessels penetrate into the lesion. 1) Peritumoral edema surrounds the whole tumor surface of high grade gliomas and metastatic brain tumors, but develops only from one part of the tumor surface of subcortical meningioma. Presumably, subcortical meningioma arises from the arachnoid cells of the pia mater within brain sulci.…”

Section: Discussionmentioning

confidence: 99%

Atypical Growth Pattern of a Meningioma in an Adult -Case Report-

Lanotte

Perez

Boccaletti

et al. 2007

Neurol. Med. Chir.(Tokyo)

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A 49-year-old woman presented with a rare atypical growth pattern of meningioma without evidence of dural attachment manifesting as chronic headache associated with transient paresthesia and left motor disorders. On admission, neurological examination showed no abnormalities. Magnetic resonance (MR) imaging revealed a right temporo-parieto-occipital lesion, which appeared to involve the subdural space and filling the cortical sulci. The lesion caused peritumoral white matter edema. The tumor appeared hypointense on T 1 -weighted and hyperintense on T 2 -weighted MR images, with homogeneous enhancement after contrast administration. A biopsy of the lesion was performed. Histological examination indicated that the lesion was a meningioma. Intraparenchymal meningiomas should be considered in the differential diagnosis of intraaxial lesions in patients of any age.

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“…A magnitude do edema peritumoral produzido varia amplamente. Muitos fatores têm sido analisados como determinantes do edema, entre eles localização, tamanho do tumor, diferenciação histológica 25,31,33 e vascularização pial 34 .…”

Section: Fig 3 Corte Axial De Exame De Ressonância Magnética Após Inunclassified

Meningiomas supratentoriais: diagnóstico, resultados cirúrgicos e complicações

Figueiredo

Aguiar

Córdoba

et al. 1998

Arq. Neuro-Psiquiatr.

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-Meningiomas are benign tumors arisising from arachnoid cells and represent the commonest asymptomatic intracranial tumors. We analysed 69 supratentorial meningiomas managed by the Neurosurgical Tumor Group of the Clinics Hospital of Medicine School of São Paulo University (September 1995 to September 1997. Age, sex, edema degree, tumor site, surgical complications and mortality were studied. Edema degree was defined by radiological methods (CT and MRI). Forty-seven patients were women and average age was 58 years. Type II of edema degree was predominant (38.7%). Twenty-nine patients had parasagital meningiomas and 40 presented convexity tumors. Simpson I resection was obtained in 48 procedures, II in 18 and III in two surgical removals. Nine cases complicated (transitory deficits, 6; permanent deficit, 1; and infection, 2). Death occurred in two patients. Morbity and mortality had relation with age, falx tumors and attempt of radical surgical removal. Edema degree did not modify mortality and morbity rates.KEY WORDS: supratentorial meninigiomas, surgery, brain edema, venous sinus.Os meningiomas são tumores originados de células das vilosidades aracnóideas e constituem os tumores intracranianos assintomáticos mais comuns. Representam cerca de 13-18% dos tumores intracranianos primitivos 1,2 , atingindo mais frequentemente indivíduos com idade entre 20 e 60 anos e acomentendo principalmente o sexo feminino. 3

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The importance of pial blood supply to the development of peritumoral brain edema in meningiomas

Cited by 90 publications

References 35 publications

Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning

Predicting the probability of meningioma recurrence based on the quantity of peritumoral brain edema on computerized tomography scanning

Atypical Growth Pattern of a Meningioma in an Adult -Case Report-

Meningiomas supratentoriais: diagnóstico, resultados cirúrgicos e complicações

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