While the surgical and neurological risks of meningioma surgery have been reported, much less effort has been devoted to studying the rates of serious medical complications following such a procedure. The authors performed a review of 834 patients who underwent craniotomy for meningioma at their institution and analyzed the rate of major cardiac, pulmonary, renal, and hepatic complications.
The authors identified all patients between 1993 and 2007 who underwent craniotomy for meningioma. Clinical information was reconstructed using patient medical records, medication records, radiological data, and pathological specimens from both the author institution and outside medical facilities. Stepwise multivariate logistic regression analysis was performed to test the association between the dependent variable (rate of medical complications) and all covariates with a p < 0.2 on univariate testing.
Fifty-seven patients (6.8%) experienced 61 serious medical complications following surgery for meningioma. Four patients died of medical complications. The most common complication was pneumonia, followed by renal dysfunction, arrhythmia, and deep venous thrombosis and/or pulmonary embolus. The development of a new or worsened neurological deficit (p < 0.00001), an age > 65 years (p < 0.03), hypertension (p < 0.02), and being on > 2 cardiac medications prior to surgery (p < 0.004) all demonstrated significantly increased rates of medical complications on univariate analysis. On multivariate analysis, only a new or worsened neurological deficit remained a significant risk factor for the occurrence of serious medical complications (p < 0.00001).
Overall, the authors found that the rate of clinically detected serious medical complications is relatively low in this population (6.8%), given the duration and complexity of the meningioma operations, and is strongly linked to the subsequent development of significant medical complications. This information may be useful to surgeons in discussing the morbidity of surgery during the informed consent process.
Abbreviations used in this paper: DVT = deep venous thrombosis; GTR = gross-total resection; STR = subtotal resection; UCSF = University of California, San Francisco.
Address correspondence to: Michael W. McDermott, M.D., Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Box 0112, San Francisco, California 94143. email: firstname.lastname@example.org.
Please include this information when citing this paper: published online July 23, 2010; DOI: 10.3171/2010.6.JNS091974.
AdachiKKawaseTYoshidaKYazakiTOnozukaS: ABC Surgical Risk Scale for skull base meningioma: a new scoring system for predicting the extent of tumor removal and neurological outcome. Clinical article. J Neurosurg111:1053–10612009
CageTALambornKRWareMLFrankfurtAChakalianLBergerMS: Adjuvant enoxaparin therapy may decrease the incidence of postoperative thrombotic events though does not increase the incidence of postoperative intracranial hemorrhage in patients with meningiomas. J Neurooncol93:151–1562009