Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2017 Aug:104:248-258.
doi: 10.1016/j.wneu.2017.04.159. Epub 2017 May 3.

Falcine Meningiomas: Analysis of the Impact of Radiologic Tumor Extensions and Proposal of a Modified Preoperative Radiologic Classification Scheme

Kuntal Kanti Das  1 , Jaskaran Singh Gosal  2 , Pradeep Sharma  2 , Anant Mehrotra  2 , Kamlesh Bhaisora  2 , Jayesh Sardhara  2 , Arun Srivastava  2 , Awadhesh Kumar Jaiswal  2 , Raj Kumar  2 , Sanjay Behari  2
Affiliations
Clinical Trial

Falcine Meningiomas: Analysis of the Impact of Radiologic Tumor Extensions and Proposal of a Modified Preoperative Radiologic Classification Scheme

Kuntal Kanti Das et al. World Neurosurg. 2017 Aug.

Abstract

Background: Although extensively studied, few papers have specifically addressed the surgical implications of horizontal and vertical tumor extensions in falcine meningioma (FM). The available classification systems do not address these tumor extensions and thus do not characterize FM in their entirety.

Objective: To determine the influence of radiologic tumor extensions on the clinicoradiologic and surgical aspects of FM, propose a new preoperative radiologic scheme for these tumors, and report our surgical outcomes.

Methods: Thirty-five patients with FM (mean age, 50.03 years; male/female ratio, 16:19) were classified into unilateral conventional (type I; n = 17), unilateral high (type II; n = 9) and bilateral FM (type III; n = 9) based on the coronal magnetic resonance imaging findings. We excluded the primary parasagittal meningiomas from our analysis.

Results: Type II and III tumors were more common in males (unlike the overall cohort), presented more often with seizures, and were associated with less favorable postoperative outcomes. Preoperative motor weakness was almost exclusively seen with the unilateral tumors (type I/II). Preexisting weakness (P = 0.02) was a strong predictor of the likelihood of postoperative motor power worsening, the major surgical complication in our series (n = 9; 25.7%). New-onset postoperative weakness (n = 2) recovered completely, whereas worsening of the preexisting weakness showed only a partial improvement (n = 6).

Conclusions: The proposed classification scheme characterizes FMs comprehensively. Bilaterality and parasagittal extensions in FMs affect their clinical presentation, increase surgical difficulty, and influence the surgical outcome adversely. Preexisting motor weakness portends a poor postoperative motor outcome.

Keywords: Contralateral; Falx; Outcome; Parasagittal meningioma; Surgery; Venous sinus; WHO grade.

PubMed Disclaimer

Publication types

LinkOut - more resources