Predictive factors related to symptomatic venous infarction after meningioma surgery.
BACKGROUND
The incidence of venous infarction after surgical resection of meningioma is low, but its occurrence can necessitate additional surgical procedures and long hospital stay. In this study, we evaluated variables associated with venous infarction after meningioma surgery.


METHODS
Among 825 patients with intracranial meningiomas who underwent microsurgical resection between January 1993 and March 2011, 27 (3.3%) presented with neurological deterioration due to postoperative venous infarction. The following factors were included in the statistical analysis to determine their association with venous infarction: sex, age, location, relation to venous sinus, peritumoural oedema, size and degree of resection.


RESULTS
Incidence of venous infarction was 6.8% with large meningiomas (size ≥ 4 cm), but with small (size < 4 cm) was reduced to 1.2% (p < 0.001). Meningiomas with perilesional edema elicited venous infarction more frequently than those without (5.1% vs. 2.3%, p = 0.030). Venous infarction was also determined to occur at 5.5% frequency in superficial meningiomas, such as parasagittal, falx and convexity, but only at 0.5% frequency in deep locations (p = 0.001). Venous infarction additionally occurred less often in meningiomas at a distance from the midline venous sinus than in those nearby, such as parasagittal and falx (2.2% vs. 6.6%, p = 0.004).


CONCLUSIONS
To prevent venous infarction after meningioma surgery, it is essential to maintain the intervening arachnoid plane as much as possible; this is especially important in meningiomas larger than 4 cm, combined with peritumoural edema or positioned superficially around the midline venous sinus.
Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Gwangju, South Korea.
Woo-Youl
WY
Jang
Shin
S
Jung
Tae-Young
TY
Jung
Kyung-Sub
KS
Moon
In-Young
IY
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000209:etiology; D020520:Brain Infarction / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed