gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Meningiomas located adjacent to the central region – a microsurgical outcome study

Meeting Abstract

  • Christian Rosenstengel - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Germany
  • Marc Matthes - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Germany
  • Steffen Fleck - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Germany
  • Ehab El Refaee - Department of Neurosurgery, Cairo University, Cairo, Egypt
  • Henry Schroeder - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Germany
  • Jörg Baldauf - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.04.05

doi: 10.3205/16dgnc019, urn:nbn:de:0183-16dgnc0194

Published: June 8, 2016

© 2016 Rosenstengel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Surgery of parasagittal or convexity meningiomas is influenced by several pathoanatomical aspects such as respect to arachnoid membranes, blood supply, relation to peritumoral veins or sagittal sinus. The aim of this retrospective study was to analyze surgical outcome, complications and risk factors of microsurgical therapy for central region meningiomas.

Method: Between 2006 and 2015 446 patients have been treated for 483 meningiomas of different locations at our institution. Out of this number the study revealed 29 consecutive patients (median age 62 years) who underwent surgery for meningiomas located adjacent to the central region.

Results: Meningiomas were diagnosed as an incidental finding (12), due to hemiparesis (13) or epileptic seizures (4). Peritumoral edema was observed in 14 cases. All 29 patients underwent microsurgical resection. When arachnoid layers were not respected by the tumor, remnants of the tumor capsule were left in place. After surgery, deterioration of preexisting functional deficits and new deficits were observed in 5 and 3 patients respectively. Within this group of patients, sagittal sinus injury was observed intraoperatively once. One bridging vein was sacrificed accidentally. CT-Scans demonstrated new or progressive perifocal edema as a sign for venous congestion in 7 patients. Additionally, a subcortical intracerebral hemorrhage occurred in one case. Another patient underwent surgery for a postoperative epidural hematoma and one because of a wound infection. A Simpson Grade I, II, III or IV resection was performed in 12, 3, 4 and 10 patients respectively. Median follow-up was 39 months (range: 3 to 98 months). During the follow-up period, the neurological deficits resolved completely in 12 and improved in 4 patients. In 4 patients with Simpson grade IV resection, tumor progression was observed in the follow-up period.

Conclusions: There was a high risk of clinical deterioration in this group of patients (27.5%) in the early phase after surgery. Radical tumor removal when the tumor did not respect the arachnoid, peritumoral edema, injury to bridging veins or to the sinus itself increased the probability of postoperative complications. However, progressive venous congestion recovers over time and the clinical status completely improved in most of the patients during follow-up. Based on our results every patient with a central region meningioma should be informed before surgery about a serious risk of transient neurological deficits.