Assessment of Structural and Topographic Characteristics of Meningiomas from the Standpoint of Surgical Treatment Tactics
A high risk of damaging critical neurovascular structures arises at the attempt of radical meningiomas elimination. Partial removal of the tumor reduces the risk of intraoperative losses, but inevitably increases the recurrence rate. Palliative operations preserve the quality of patient’s life, but make them victims of repeated operative interventions.
The aim of the investigation was to define structural and topographic characteristics of meningiomas of various locations from the standpoint of surgical treatment tactics.
Materials and Methods. Analysis of the author’s own data on treatment of meningiomas in Nizhny Novgorod Interregional Neurosurgical Center has been carried out. 127 patients, aged 20–73 years, received surgical treatment in the period from 2000 to 2014, have been examined. The follow-up period covered from 2 months — to 7 years.
Results. Based on the knowledge of tumor structural integrity, meningioma’s fractal patterns have been identified. Various types of its structure are determined by meningioma’s internal properties and realize in the process of their growth. Two models of meningioma growth have been suggested. Diverse surgical tactics of tumor removal, minimizing probable operative losses, have been considered.Conclusion. The principle of meningioma structural analysis, taking into account peculiarities of its structure, growth and topography, allows the surgeon to plan and realize an adequate surgical tactics, minimizing the intensity of operative complications.
- Tigliev G.S., Olyushin V.E., Kondrat'ev A.N. Vnutricherepnye meningiomy [Intracranial meningiomas]. Saint Petersburg; 2001; 560 p.
- Alexiou G.A., Gogou P., Markoula S., Kyritsis A.P. Management of meningiomas. Clin Neurol Neurosurg 2010 Apr; 112(3): 177–182, http://dx.doi.org/10.1016/j.clineuro.2009.12.011.
- Dolecek T.A., Propp J.M., Stroup N.E., Kruchko C. CBTRUS Statistical Report: primary brain and central nervous system tumors diagnosed in the United States in 2005–2009. Neuro Oncol 2012; 14(Suppl 5): v1–v49, http://dx.doi.org/10.1093/neuonc/nos218.
- Wiemels J., Wrensch M., Claus E.B. Epidemiology and etiology of meningioma. J Neurooncol 2010; 99(3): 307–314, http://dx.doi.org/10.1007/s11060-010-0386-3.
- Konovalov A.N., Kozlov A.V., Cherekaev V.A., Shimanskii V.N., Taniashin S.V., Kornienko V.N., Pronin I.N., Golanov A.V., Kobiakov G.L., Shishkina L.V., Ryzhova M.V., Gol'bin D.A., Galkin M.V., Bocharov A.A., Lasunin N.V. Meningioma challenge: analysis of 80-year experience of Burdenko Neurosurgical Institute and future perspectives. Voprosy neyrokhirurgii im. N.N. Burdenko 2013; 77(1): 12–23.
- Cherekaev V.A., Belov A.I., Vinokurov A.G. Khirurgiya giperostoticheskikh kranioorbital'nykh meningiom [Surgery of hyperostotic cranio-orbital meningiomas]. Pod red. A.N. Konovalova. Moscow; 2009; 305 p.
- Cherekaev V.A., Spirin D.S., Kadasheva A.B., Kozlov A.V., Mikhalkova A.A., Mukhametzhanov D.Zh., Rotin D.L., Galkin M.V., Lasunin N.V., Grigor’eva N.N. Orbitosphenopetroclival meningiomas: clinical and topographic features and results of combined treatment. Voprosy neyrokhirurgii im. N.N. Burdenko 2013; 77(2): 11–22.
- Korshunov A., Cherekaev V., Bekyashev A., Sycheva R. Recurrent cytogenetic aberrations in histologically benign, invasive meningiomas of the sphenoid region. J Neurooncol 2007; 81(2): 131–137, http://dx.doi.org/10.1007/s11060-006-9214-1.
- Behari S., Giri P.J., Shukla D., Jain V.K., Banerji D. Surgical strategies for giant medial sphenoid wing meningiomas: a new scoring system for predicting extent of resection. Acta Neurochir (Wien) 2008; 150(9): 865–877, http://dx.doi.org/10.1007/s00701-008-0006-6.
- Yang J., Fang T., Ma S., Yang S., Qi J., Qi Z., Cun E., Yu C. Large and giant petroclival meningiomas: therapeutic strategy and the choice of microsurgical approaches — report of the experience with 41 cases. Br J Neurosurg 2011; 25(1): 78–85, http://dx.doi.org/10.3109/02688697.2010.539716.
