TY - JOUR
T1 - Predictive factors for post operative seizures following meningioma resection in patients without preoperative seizures
T2 - a multicenter retrospective analysis
AU - McKevitt, Chase
AU - Marenco-Hillembrand, Lina
AU - Bamimore, Michael
AU - Chandler, Rosemary
AU - Otamendi-Lopez, Andrea
AU - Almeida, Joao Paulo
AU - Quiñones-Hinojosa, Alfredo
AU - Chaichana, Kaisorn L.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
PY - 2023/5
Y1 - 2023/5
N2 - Purpose: Meningiomas are the most common primary brain tumor and represent 35% of all intracranial neoplasms. However, in the early post-operative period approximate 3–5% of patients experience an acute symptomatic seizure. Establishing risk factors for postoperative seizures will identify those patients without preoperative seizures at greatest risk of postoperative seizures and may guide antiseizure medications (ASMs) management. Methods: Adult seizure naïve patients who underwent primary resection of a World Health Organization (WHO) Grade 1–3 meningioma at the three Mayo Clinic Campuses between 2012–2022 were retrospectively reviewed. Multivariate regression analyses were used to identify radiological, surgical, and management features with the development of new-onset seizures in patients undergoing meningioma resection. Results: Of 113 seizure naïve patients undergoing meningioma resection 11 (9.7%) experienced a new-onset post-operative seizure. Tumor volume ≥ 25 cm3 (Odds Ratio (OR) 5.223, 95% Confidence Interval (CI) 1.546 – 17.650, p = 0.008) and cerebral convexity meningiomas (OR 4.742, 95% CI 1.255 – 14.336, p = 0.016) were most associated with new onset postoperative seizures in multivariate analysis. ASMs and corticosteroid therapies did not display a significant difference among those with and without a new onset postoperative seizure. Conclusion: In the current study, a larger tumor volume (≥ 25 cm3) and/or convexity meningiomas predicted the development of new onset post-operative seizures. Those who present with these factors should be counseled for their increased risk of new onset post-operative seizures and may benefit from prophylactic ASMs therapy.
AB - Purpose: Meningiomas are the most common primary brain tumor and represent 35% of all intracranial neoplasms. However, in the early post-operative period approximate 3–5% of patients experience an acute symptomatic seizure. Establishing risk factors for postoperative seizures will identify those patients without preoperative seizures at greatest risk of postoperative seizures and may guide antiseizure medications (ASMs) management. Methods: Adult seizure naïve patients who underwent primary resection of a World Health Organization (WHO) Grade 1–3 meningioma at the three Mayo Clinic Campuses between 2012–2022 were retrospectively reviewed. Multivariate regression analyses were used to identify radiological, surgical, and management features with the development of new-onset seizures in patients undergoing meningioma resection. Results: Of 113 seizure naïve patients undergoing meningioma resection 11 (9.7%) experienced a new-onset post-operative seizure. Tumor volume ≥ 25 cm3 (Odds Ratio (OR) 5.223, 95% Confidence Interval (CI) 1.546 – 17.650, p = 0.008) and cerebral convexity meningiomas (OR 4.742, 95% CI 1.255 – 14.336, p = 0.016) were most associated with new onset postoperative seizures in multivariate analysis. ASMs and corticosteroid therapies did not display a significant difference among those with and without a new onset postoperative seizure. Conclusion: In the current study, a larger tumor volume (≥ 25 cm3) and/or convexity meningiomas predicted the development of new onset post-operative seizures. Those who present with these factors should be counseled for their increased risk of new onset post-operative seizures and may benefit from prophylactic ASMs therapy.
KW - Brain tumor
KW - Meningioma
KW - Seizures, Resection
KW - Surgery
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U2 - 10.1007/s00701-023-05571-0
DO - 10.1007/s00701-023-05571-0
M3 - Article
C2 - 36977866
AN - SCOPUS:85151118637
SN - 0001-6268
VL - 165
SP - 1333
EP - 1343
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 5
ER -