title: The importance of pial blood supply to the development of peritumoral brain edema in meningiomas.
abstract: In a retrospective analysis, the authors studied the pial and dural blood supplies in 74 intracranial meningiomas and quantified their associated peritumoral brain edema (PTBE). The extent and localization of pial blush in relation to the total tumor volume were determined angiographically. The amount of edema and tumor size were calculated using computerized tomography. The edema-tumor volume ratio was defined as Edema Index (EI). There were 49 meningiomas with PTBE; of those tumors, 46 were supplied by pial vessels, and three were supplied exclusively by dural vessels. Tumors without PTBE showed no pial blush. The mean EI in meningiomas with pial blush was significantly larger (EI = 3) than in meningiomas without pial supply (EI = 1.1; p < 0.0001). Meningiomas with a smaller pial supply than dural supply had a significantly smaller mean EI than tumors with a pial supply equal to or greater than the dural supply (EI = 2.9 vs. EI = 3.7; p < 0.015). In 69.9% of cases with pial blood supply, major portions of the edema were located adjacent to the tumor region supplied by pial vessels. Edema index differences among tumors of different subgroups, as defined by size or histology, were significantly related to the pial supply in each subset. Thus, pial blood supply may be associated with the development of PTBE in meningiomas.
authors.affiliation: Department of Neuroradiology, and Institute for Brain Research, University of Tübingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bitzer
authors.forename: L
authors.initials: L
authors.lastname: Wöckel
authors.forename: A R
authors.initials: AR
authors.lastname: Luft
authors.forename: A K
authors.initials: AK
authors.lastname: Wakhloo
authors.forename: D
authors.initials: D
authors.lastname: Petersen
authors.forename: H
authors.initials: H
authors.lastname: Opitz
authors.forename: T
authors.initials: T
authors.lastname: Sievert
authors.forename: U
authors.initials: U
authors.lastname: Ernemann
authors.forename: K
authors.initials: K
authors.lastname: Voigt
mesh_terms: D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D001932:Brain Neoplasms / Q000098:blood supply / Q000150:complications* / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply / Q000150:complications* / Q000000981:diagnostic imaging; D008579:Meningioma / Q000098:blood supply / Q000150:complications* / Q000000981:diagnostic imaging; D008875:Middle Aged; D010841:Pia Mater / Q000098:blood supply*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed