Document Detail


Brain oedema in patients with intracranial meningioma. Correlation between clinical, radiological, and histological factors and the presence and intensity of oedema.
MedLine Citation:
PMID:  8800322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors analysed the correlation between different clinical, radiological, and pathological variables and the presence and intensity of brain oedema associated to intracranial meningioma in 400 consecutive patients studied by computerized tomography (CT). The following factors did not show significant correlation with brain oedema development: the age and sex of the patient, the occurrence of focal deficits, the presence of skull changes (endostosis, exostosis, osteolysis), the occurrence of tumour calcification, the density of the tumour on plain CT scan, the presence of a cystic component, the pathological subtype of meningioma (both conventional and non-conventional), and the presence of histological features of tumour aggressiveness, such as an increased vascularization, high cellularity, high mitotic index, pleomorphism, necrosis, and brain infiltration. Factors showing a statistically significant correlation with the presence and intensity of brain oedema at the bivariate analysis were: the presence of symptoms (p < 0.001), the duration of the clinical history (p < 0.05), the location and size of the tumour (p < 0.001), the type (heterogeneous vs homogeneous), and intensity of tumour contrast enhancement (p < 0.001), the presence of irregular tumour margins (p < 0.001), and the existence of focal low density intratumoural areas (p < 0.001). The multivariate analysis using only clinical parameters showed that the group of variables with the highest power for predicting the presence of brain oedema (concordance level of 76.8%) included: the presence of symptoms, the occurrence of seizures (focal or generalized), the presence of an intracranial hypertension syndrome, and the age of the patient. The multivariate analysis using only anatomico-radiological parameters showed that the model which included the size of the tumour, the intensity of contrast enhancement, the tumour margins, and meningioma location, predicted the presence of brain oedema in 80.8% of the cases. Though the results of the present study do not definitively support any of the major physiopathological theories proposed to explain brain oedema formation in patients with intracranial meningioma, some findings could favour the so-called hydrodynamic theory.
Authors:
R D Lobato; R Alday; P A Gómez; J J Rivas; J Domínguez; A Cabrera; S Madero; J Ayerbe
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica     Volume:  138     ISSN:  0001-6268     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  1996  
Date Detail:
Created Date:  1996-12-30     Completed Date:  1996-12-30     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  AUSTRIA    
Other Details:
Languages:  eng     Pagination:  485-93; discussion 493-4     Citation Subset:  IM    
Affiliation:
Service of Neurosurgery, Hospital 12 de Octubre, Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Brain / pathology,  physiopathology,  radiography
Brain Edema / pathology,  physiopathology,  radiography*
Female
Humans
Intracranial Pressure / physiology
Male
Meningeal Neoplasms / pathology,  physiopathology,  radiography*
Meningioma / pathology,  physiopathology,  radiography*
Middle Aged
Neurologic Examination
Prognosis
Retrospective Studies
Tomography, X-Ray Computed*

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