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Open Access 01-12-2024 | Meningioma | Original Article

Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3

Authors: Nico Teske, Nina C. Teske, Tobias Greve, Philipp Karschnia, Sabrina V. Kirchleitner, Patrick N. Harter, Robert Forbrig, Joerg-Christian Tonn, Christian Schichor, Annamaria Biczok

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Background

Patients with intracranial meningiomas frequently suffer from tumor-related seizures prior to resection, impacting patients’ quality of life. We aimed to elaborate on incidence and predictors for seizures in a patient cohort with meningiomas WHO grade 2 and 3.

Methods

We retrospectively searched for patients with meningioma WHO grade 2 and 3 according to the 2021 WHO classification undergoing tumor resection. Clinical, histopathological and imaging findings were collected and correlated with preoperative seizure development. Tumor and edema volumes were quantified.

Results

Ninety-five patients with a mean age of 59.5 ± 16.0 years were included. Most tumors (86/95, 90.5%) were classified as atypical meningioma WHO grade 2. Nine of 95 tumors (9.5%) corresponded to anaplastic meningiomas WHO grade 3, including six patients harboring TERT promoter mutations. Meningiomas were most frequently located at the convexity in 38/95 patients (40.0%). Twenty-eight of 95 patients (29.5%) experienced preoperative seizures. Peritumoral edema was detected in 62/95 patients (65.3%) with a median volume of 9 cm³ (IR: 0–54 cm³). Presence of peritumoral edema but not age, tumor localization, TERT promoter mutation, brain invasion or WHO grading was associated with incidence of preoperative seizures, as confirmed in multivariate analysis (OR: 6.61, 95% CI: 1.18, 58.12, p = *0.049). Postoperative freedom of seizures was achieved in 91/95 patients (95.8%).

Conclusions

Preoperative seizures were frequently encountered in about every third patient with meningioma WHO grade 2 or 3. Patients presenting with peritumoral edema on preoperative imaging are at particular risk for developing tumor-related seizures. Tumor resection was highly effective in achieving seizure freedom.

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Title: Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3
Authors: Nico Teske
Nina C. Teske
Tobias Greve
Philipp Karschnia
Sabrina V. Kirchleitner
Patrick N. Harter
Robert Forbrig
Joerg-Christian Tonn
Christian Schichor
Annamaria Biczok
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Meningioma
Meningioma
Edema
Epilepsy
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-06057-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perifocal edema is a risk factor for preoperative seizures in patients with meningioma WHO grade 2 and 3

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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