gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Predictors of pre- and postoperative seizures in patients with intracranial meningioma

Prädikatoren für prä- und postoperative Anfälle bei Patienten mit einem intrakraniellen Meningeom

Meeting Abstract

  • presenting/speaker Dorothee Spille - University hospital Muenster, Neurosurgery, Münster, Deutschland
  • Fynn Hinrichs - University Hospital Münster, Neurosurgery, Münster, Deutschland
  • Stephanie Schipmann-Miletic - University Hospital Münster, Neurosurgery, Münster, Deutschland
  • Caroline Brokinkel - University Hospital Münster, Radiology, Münster, Deutschland
  • Alborz Adeli - University Hospital Münster, Radiology, Münster, Deutschland
  • Peter Sporns - University Hospital Münster, Radiology, Münster, Deutschland
  • Katharina Hess - University Hospital Münster, Neuropathology, Münster, Deutschland
  • Oliver Grauer - University Hospital Münster, Neurology, Münster, Deutschland
  • Werner Paulus - University Hospital Münster, Neuropathology, Münster, Deutschland
  • Walter Stummer - University Hospital Münster, Neurosurgery, Münster, Deutschland
  • Benjamin Brokinkel - University Hospital Münster, Neurosurgery, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV246

doi: 10.3205/21dgnc232, urn:nbn:de:0183-21dgnc2326

Veröffentlicht: 4. Juni 2021

© 2021 Spille et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Although pre- and postoperative seizures in patients with intracranial meningiomas are commonly observed, pathogenesis is largely obscure and risk factors for seizure development remain controversial.

Methods: To identify correlations between the occurrence of epileptic seizures and clinical, histopathological and radiological parameters, retrospective uni- and multivariate analyses were performed.

Results: Of 945 included surgically-naïve patients (689 females, 73% and 265 males, 27%; median age: 58 years) being operated between 1991 and 2018, 189 patients (20%) suffered from preoperative seizures. Male gender (OR: 1.91, 95%CI 1.37-2.68; p<.001), grade II/III histology (OR: 2.24, 95%CI 1.46-3.46; p<.001), brain invasion (OR: 2.59, 95%CI 1.45-4.63; p=001), non-skull base tumor location (OR: 3.07, 95%CI 2.13-4.41; p<.001), heterogeneous contrast-enhancement (OR: 1.60, 95%CI 1.04-2.46; p=.031), intratumoral calcifications (OR: 1.91, 95%CI 1.17-3.10; p=.009), an irregular shape (OR: 2.07, 95%CI 1.32-3.26; p=.002) as well as tumor (OR: 1.01 per ccm, 95%CI 1.00-1.02;p=.001) and edema volumes (OR: 1.01 per ccm, 95%CI 1.00-1.01; p<.001) were correlated with seizures in univariate analyses. Multivariate analyses confirmed only non-skull base tumor location (OR: 3.12, 95%CI 1.74-5.59; p<.001) and a rising peritumoral edema volume (OR: 1.01 per ccm, 95%CI 1.00-1.01; p<.001) as independent predictors for preoperative seizures. Furthermore, of 752 preoperatively seizure-naive patients (569 females (76%) and 183 males (24%); median age: 57 years) 69 (9%) presented postoperative seizures. In univariate analyses, a correlation between seizures and the preoperative Karnofsky Score <80 (OR: 1.91, 95%CI 1.01-3.59; p=.045), convexity/ parasagittal tumor location (OR: 1.77, 95%CI 1.06-2.95; p=.030), heterogeneous contrast-enhancement (OR: 2.24, 95%CI 1.14-4.39; p=.019) and intratumoral calcifications (OR: 3.35, 95%CI 1.59-7.05; p=.001) was determined. In multivariate analyses, postoperative seizures correlated with the age at the time of surgery (OR: 1.04, 95%CI 1.01-1.07; p=.009) and intratumoral calcifications on preoperative imaging (OR: 3.70, 95%CI 1.73-7.92; p=.001).

Conclusion: MR imaging contains important information to further asses the risk of pre- and postoperative seizure development in patients with intracranial meningiomas. In contrast, clinical and histological risk factors as well as independent predictors for seizures are sparse.