gms | German Medical Science

Objective: Removal of skull-base meningiomas is challenging, and besides emphazising post-operative neurological deficits, life-quality and cognition were put into the focus assessing outcome and considering treatment recommendations.

Method: In this prospective study 58 patients underwent neurological examination and neuropsychological testing by a neuro-psychologist at 3 time-points prior (1 day) and post surgery (3 and 12 months). For neuropsychological assessments different tests were used: EORTC questionnaire (life-quality), HADS scale (depression), VLML test (memory, learning), and the TMT-A/B test (attention, executive functioning, cognitive speed). For statistical analyses the Qui-quadrate test, the Wilcoxon test, and the Pearson correlation were exerted.

Results: In this current study, 58 patients were included. Tumors were located predominately in the frontal cavity (n=31) and had an average size of 38x32mm. On admission, 51 patients had cranial nerve deficits. Since tumor infiltration into vessels, the cavernous sinus or the osseous skull-base, in 9 patients tumor resections remained subtotal. 3 months after surgery, in 5 patients deterioration of symptoms persisted. In the neuropsychological testing there was no correlation between life-quality and symptoms, post-operative deficits, tumor size or location, and age. Tumor size and age, however, showed significant negative effects on cognitive abilities after surgery expressed by the TMT, VLMT, recognition, and figurative memory (p<0.05).

Conclusions: Tumor size and age of patients with skull-base meningiomas of the frontal cavity affect cognitive abilities after surgery; life-quality, however, was not significantly affected.