title: Contralateral meningeal artery supply of paramedian meningiomas.
abstract: BACKGROUND
  When resecting at falcine or parasagittal portion of paramedian meningiomas, intraoperative hemostasis often is difficult despite effective management of ipsilateral meningeal arteries. We attribute such difficulties to meningeal artery blood supply from the contralateral side. We retrospectively studied feeding arteries from both sides in case of paramedian meningioma in terms of patient and tumor characteristics.
  
  
  METHODS
  Forty-three patients with paramedian meningiomas underwent selective internal and external carotid angiography. We investigated how contralateral meningeal arterial feeders related to patient profiles and imaging, histopathologic, and immunohistochemical findings.
  
  
  RESULTS
  Contralateral meningeal supply existed for 14 of 25 falcine meningiomas and 6 of 18 parasagittal meningiomas. Patients with contralateral feeders were 8.5 years younger than the others (P=.027) and were more likely to have larger tumors (P=.028). These were histopathologically malignant (P=.048), while showing more proliferation followed by monoclonal antibody against the Ki-67 antigen index (P=.012) and angiogenetic potential associated with vascular endothelial growth factor expression (P=.0085).
  
  
  CONCLUSIONS
  Contralateral meningeal supply may reflect strong angiogenetic recruitment from rapid tumor growth followed by high expression of vascular endothelial growth factor. This angiographical feature may predict the aggressive growth of paramedian meningiomas.
authors.affiliation: Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan. g-marble@yc4.so-net.ne.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Hattori
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyachi
authors.forename: Nozomu
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Takao
authors.initials: T
authors.lastname: Kojima
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hattori
authors.forename: Makoto
authors.initials: M
authors.lastname: Negoro
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshida
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nagasaka
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000974:Antibodies, Antinuclear / Q000378:metabolism; D000911:Antibodies, Monoclonal / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008576:Meningeal Arteries / Q000000981:diagnostic imaging*; D008577:Meningeal Neoplasms / Q000098:blood supply* / Q000175:diagnosis* / Q000378:metabolism; D008579:Meningioma / Q000098:blood supply* / Q000175:diagnosis* / Q000378:metabolism; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D018952:Antigens, CD34; C440408:MIB-1 antibody; D042461:Vascular Endothelial Growth Factor A