gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Clinical effect of brain edema in patients with intracranial meningiomas

Der klinische Effekt des Hirnödems bei Patienten mit intrakraniellen Meningeomen

Meeting Abstract

  • presenting/speaker Hajrullah Ahmeti - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Neurochirurgie, Campus Kiel, Kiel, Deutschland
  • Amke Caliebe - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Neurochirurgie, Campus Kiel, Kiel, Deutschland
  • Christoph Röcken - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Neurochirurgie, Campus Kiel, Kiel, Deutschland
  • Olav Jansen - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Neurochirurgie, Campus Kiel, Kiel, Deutschland
  • Maximilian Mehdorn - Universitätsklinikum Schleswig-Holstein, Campus Kiel, Neurochirurgie, Campus Kiel, Kiel, Deutschland
  • Michael Synowitz - Universitätsklinikum Schleswig-Holstein, Neurochirurgie, Campus Kiel, Kiel, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP123

doi: 10.3205/22dgnc433, urn:nbn:de:0183-22dgnc4339

Published: May 25, 2022

© 2022 Ahmeti et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Brain edema is a common co-manifestation in intracranial meningiomas (IMs). Many studies have been published investigating the pathogeneses of brain edema (BE) and many various factors involved in the development of BE in patients with IMs. However, there are known very few information about the effect of BE on clinical symptoms and neurological deficits. The proposal of this study was to examine the effect of BE on preoperative and postoperative symptoms and neurological deficits.

Methods: In this study, 696 patients were included who underwent surgery for primary IMs in our department between 2003 and 2019. Patients demographics, tumor and treatment characteristics, and follow-up data were collected by using the medical records.

Results: Preoperatively, 627 (90.1%) patients were symptomatic. Patients with small to moderate BE and severe BE had more often symptoms and neurological deficits, 188 (90.8%) patients and 125 (98.4%) patients, respectively, compared to 314 (86.7%) patients without BE. Preoperatively, cognitive deficits, palsy, seizure, aphasia and olfactory dysfunction were more frequent presented in patients with BE than in patients without BE. Patients with severe BE suffered significantly more often on headache.

Postoperatively, 36.6% of patients had complications. The complications rate was significantly higher in patients with BE, 41.4% of patients with small to moderate BE and 52.8% of patients with severe BE, compared to 28.2% of patients without BE. The multiple logistic regressions analysis revealed a significant correlation between postoperative bleeding, aphasia, delirium, ischemic infarction, pneumonia and BE. Furthermore, patients with BE required more often medical support. Thus, 24.2% of patients with small to moderate BE and 26% of patients with severe BE were transferred to rehabilitation or other hospital for further treatment, compared to only 11.6% of patients without BE. In addition, morality rate was higher in patients with BE direct postoperatively and in the follow-up period. The neurological condition of all patients improved in the follow-up and did not showed significant difference between patients without and with preoperative BE.

Conclusion: Preoperative BE increased significantly the risk for preoperative and postoperative symptoms and neurological deficits in patients with IMs. After surgery, patients with BE required more often medical support than patient without BE. However, all patients benefit from surgery during the course of time.