title: Pre-operative and post-operative cognitive deficits in patients with supratentorial meningiomas.
abstract: OBJECTIVE
  Cognitive deficits caused by extra-axial benign brain tumors like meningiomas and the course of these deficits after surgery is not well known. The aim of the study is to assess the pre-operative and post-operative cognitive functions in patients with meningiomas in the supratentorial compartment.
  
  
  METHODS
  In this prospective study, patients with clinico-radiological diagnosis of supratentorial meningioma, operated upon and later confirmed by histopathological examination, were included. The patients were evaluated for cognitive deficits before and after surgery. The various clinical and radiological factors influencing the cognitive status were evaluated.
  
  
  RESULTS
  A total of 57 patients were enrolled into the study. Out of 57, 22 were males and 35 were females. The frontal group had 22 patients, the parietal group had 10 patients, the temporal group had 10 patients, the occipital group had 6 patients, and the suprasellar group had 9 patients. Meningiomas, although extra-axial, caused significant cognitive deficits in 42 patients (73.7%). The highest frequency of cognitive deficits is seen in the frontal and temporal group of meningiomas (90% each). Frontal meningiomas with volume greater than 35 cc and peritumoral edema greater than 40 cc caused a higher frequency of cognitive deficits. Also, patients with raised ICP had significant cognitive deficits. Postoperatively there was a significant improvement in the cognitive functions in the frontal and temporal groups.
  
  
  CONCLUSIONS
  Meningiomas cause cognitive deficits in 73.7% of patients. Anatomical location of meningioma, elevated ICP, the volume of meningioma and extent of peritumoral edema significantly influence the incidence of cognitive deficits. Post-operatively, the cognitive deficits improve significantly in the frontal and temporal group.
authors.affiliation: Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India. Electronic address: kalyan98omc@yahoo.co.in.
authors.forename: Kalyan
authors.initials: K
authors.lastname: Bommakanti
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
authors.forename: Shanmukhi
authors.initials: S
authors.lastname: Somayajula
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
authors.forename: Alladi
authors.initials: A
authors.lastname: Suvarna
authors.affiliation: Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
authors.forename: Aniruddh Kumar
authors.initials: AK
authors.lastname: Purohit
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
authors.forename: Shailaja
authors.initials: S
authors.lastname: Mekala
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
authors.forename: Santoshi Kumari
authors.initials: SK
authors.lastname: Chadalawadi
authors.affiliation: Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
authors.forename: Padmaja
authors.initials: P
authors.lastname: Gaddamanugu
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D015173:Supratentorial Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult
keywords: Cognitive; Meningioma; Post-operative