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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Clinical symptoms, surgical approaches and clinical outcome in a series of 153 frontobasal meningiomas

Meeting Abstract

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  • C. Schlimper - Neurochirurgische Klinik, Universitätsklinikum Bonn
  • A. Brühl - Philosophisch-theologische Hochschule der Pallottiner Vallendar, Vallendar
  • R. Kristof - Neurochirurgische Klinik, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.11-03

DOI: 10.3205/09dgnc073, URN: urn:nbn:de:0183-09dgnc0730

Published: May 20, 2009

© 2009 Schlimper et al.
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Outline

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Objective: Frontobasal meningiomas may be challenging because of their proximity to arteries of the anterior circulation, anterior visual pathway, olfactory nerves, and the hypothalamus. The authors report on the clinical symptoms, surgical procedures and the clinical outcome after surgical treatment of frontobasal meningiomas at their institution.

Methods: Clinical, radiological and surgical data in a consecutive series of patients operated for frontobasal meningiomas 1990–2007 were reviewed retrospectively. Follow-up ranged from 10 months to 14 years.

Results: Of the 153 patients, 104 were women and 49 men (mean age 57 years). The most common preoperative symptoms were visual impairment in 41%, followed by mental changes in 36% and anosmia in 33% of the patients.

The olfactory groove (54 patients) and tuberculum sellae (43 patients) were the most frequent tumour locations.

The tumors were resected mainly via frontolateral (54 cases) and bifrontal (37 cases) approaches. In most cases (n=93) total tumor removal with excision of the dural attachment (Simpson grade I) was achieved. 141 meningiomas were WHO grade I, 9 tumors were WHO grade II and 3 meningiomas diagnosed as WHO grade III.

Olfaction was preserved in 61% of patients with olfactory meningiomas. Mental disturbance improved in 39% of the affected patients. 37% of the affected patients with tuberculum sellae or planum sphenoidale meningiomas had improved visual acuity. Visual improvement was dependent on the duration of preoperative visual symptoms.

Complications occurred in 39% of the patients. 77% of the complications were reversible. The mortality rate was 10%.

Conclusions: Even in large frontobasal meningiomas, high rates of complete tumor resection can be achieved, while functional outcome is improved as compared to preoperative state.