Contralateral meningeal artery supply of paramedian meningiomas.
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.
Hattori
Koji
K
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan. g-marble@yc4.so-net.ne.jp
Miyachi
Shigeru
S
Kobayashi
Nozomu
N
Kojima
Takao
T
Hattori
Ken-Ichi
K
Negoro
Makoto
M
Yoshida
Jun
J
Nagasaka
Tetsuro
T
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
D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D018952:Antigens, CD34; C440408:MIB-1 antibody; D042461:Vascular Endothelial Growth Factor A