Analytical review of 100 cases of intracranial meningioma with special attention to both CT-scan results and recurrency factors

Summary: Out of 100 cases of meningiomas operated during years 1983-1994, 52% were female and 48% were male patients. Age range was 18-78 years with an average of 47.4 ± 12.1 years. On clinical examination the main symptoms observed were headache, convulsions, motor weakness and visual problems, while mild hemiparesis, papil edema, facial palsy and optic atrophy were the most prevalent clinical signs. Neurological examination revealed that 24% of the patients were normal and 11% received low dose radiation for the treatment of scabies during childhood. The prevalences of the origin of meningiomas were respectively as follows: Parasagittal falx 33%, Cerebral convixity 32%, Sphenoid ridge 10% Para- and supra-sellar region 7%, Olfactory grooves 5%, Posterior fossa 4%, Sphenoorbital 3%, Temporal base 3%, Peritorcular 2% and intraventricular 1%. Eighty seven percent of meningiomas were benign while the a typical and malignant type composed 13% of the cases. All patients were CT-Scanned with or without contrast injection. The prevalence of a typical CT-Scans was significantly higher in malignant cases (P < 0.0005). Different surgical approaches were performed as follows: Total tumor resection either with the resection of the origin (first degree) of by coagulation of the origin (2nd degree) 68%, subtotal resection (4th degree) 13% and partial resection for the first time because of close similarity between the tumor and gliomas 4%. Sixty two months follow up studies showed 18% tumor recurrence. Inverse relation was found between the extent of tumor resection and its recurrence (P < 0.0005) and between malignancy and recurrence (P < 0.001), while age and sex were not related to the recurrence of meningioma (P < 0.10). Since in a large number of patients despite having meningioma there were no obvious clinical signs, it is highly recommended that in cases of chronic non specific headaches and in different kinds of epilepsy, even if clinical examination reveal normal, the patient should be worked up for topographic diagnosis (contrast CT-Scan or MRI). Also upon surgery as far as possible, total resection of meningioma should be performed in order to prevent recurrence.