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. 2020 Sep;162(9):2155-2163.
doi: 10.1007/s00701-020-04244-6. Epub 2020 Feb 3.

Indications and outcome in surgically treated asymptomatic meningiomas: a single-center case-control study

Olivia Näslund  1   2   3 , Thomas Skoglund  4   5 , Dan Farahmand  5 , Thomas O Bontell  4   6 , Asgeir S Jakola  4   5   7
Affiliations

Indications and outcome in surgically treated asymptomatic meningiomas: a single-center case-control study

Olivia Näslund et al. Acta Neurochir (Wien). 2020 Sep.

Abstract

Background: Many meningiomas are detected incidentally and remain asymptomatic until intervention. The goal of this study was to describe the management and outcome in this group of surgically treated asymptomatic meningiomas.

Methods: From 2004 to 2017, 45 patients with asymptomatic meningioma were surgically treated at Sahlgrenska University Hospital, and their medical records and imaging data were analyzed. The asymptomatic cases were matched with symptomatic ones with respect to age at diagnosis, location, WHO (World Health Organization) grade, and Simpson grade.

Results: Time from diagnosis to surgery differed between the asymptomatic and symptomatic patients (8.6 vs. 1.3 months; p < 0.001). Of symptomatic patients, 32.6% still used anti-epileptic drugs > 1 year after surgery, compared with 7.7% of the asymptomatic (p = 0.003). Thirty-day complication rate was significantly higher among the asymptomatic cases (35.6% vs. 24.4%; 0.001), as well as the proportion of older asymptomatic individuals (> 70 years) experiencing postoperative complication compared with symptomatic patients of the same age group.

Conclusion: As expected, asymptomatic cases had smaller tumors and waited longer for surgery. Surprisingly, complication rate was significantly higher among asymptomatic cases compared with their symptomatic control. Taken into account that many asymptomatic tumors are removed surgically due to patient's wish, one might suggest a more restrictive approach, especially in the elderly.

Keywords: Asymptomatic; Meningioma; Outcome; Postsurgical complication.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Resulting flowchart of search strategy
Fig. 2
Fig. 2
Representative T1-GD axial slice from the diagnostic MRI examination and cause of first radiological scan among asymptomatic patients. Left to right, patient 1 (upper left) through patient 45 (lower right). 1. InfarctionD, 2. migraine, 3. idiopathic intracranial hypertension, 4. trauma, 5. depression, 6. vertigo*, 7. control of head/neck cancer*, 8. numbness in hand and arm*, 9. pulsating sensation in earS, 10. fainting, 11. meningitis, 12. migraine*, 13. neck painS, 14. examination before pregnancy*, 15. vertigo, 16. idiopathic intracranial hypertension*, 17. shaking in thumb caused by exertion, 18. control patient in study, 19. infarction*, 20. neck pain, 21. hallucinations, 22. vertigo*, 23. pain behind eye*S, 24. neck pain*, 25. infection of unspecified origin, 26. control of head/neck cancer*, 27. trauma, 28. traumaD, 29. control of head/neck cancer, 30. migraine*, 31. migraine*, 32. sepsis*D, 33. neck pain*, 34. examination of vestibula schwannoma, 35. neck pain*, 36. periorbital lipoma*, 37. trauma*D, 38. transient hearing loss*, 39. migraine*, 40. unspecified symptoms from ear*, 41. meningitis, 42. transient hearing loss, 43. control head/neck cancer*, 44. follow-up exam oligodendroglioma*, 45. fatigue*. The asterisk indicates growth prior to surgery. D indicates new onset deficit postoperatively. S indicates new onset seizure postoperatively
See this image and copyright information in PMC

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