Incidence, risk factors, and outcome of venous infarction after meningioma surgery in 705 patients

Michael E. Sughrue, Martin J. Rutkowski, Gopal Shangari, Shanna Fang, Andrew T. Parsa, Mitchel S. Berger, Michael W. McDermott

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Central to safe and effective surgical resection of meningiomas is consideration of the venous anatomy both near and intrinsic to the tumor. The exact incidence of venous infarction following meningioma surgery has not been established. To determine this incidence, we present a large multivariate analysis of 705 patients undergoing craniotomy for resection of a histologically proven meningioma at our institution between 1991 and 2007. Clinical information was retrospectively reconstructed using patient medical records and radiologic data. Venous infarctions were identified by postoperative CT scans or MRI that demonstrated the typical imaging findings. Stepwise multivariate logistic regression analysis was performed to test the association with approach used and the rate of venous infarction, controlling for multiple independent variables. The overall rate of venous infarction (n = 705) was 2.0% of all patients (95% confidence interval [CI], 0.9-3.0%). Interestingly, on multivariate logistic regression analysis, we found the use of a bifrontal craniotomy was the sole independent predictor of venous infarction in this regression model (odds ratio, 3.18; 95% CI, 1.03-9.77; p < 0.05). We found that the rate of venous infarction was significantly reduced in the extended bifrontal group compared to the group not receiving biorbital osteotomies (0% versus 8.9%, χ2 p < 0.05). We demonstrated that the most important factor determining the risk of venous infarction is the approach used to access the tumor.

Original languageEnglish (US)
Pages (from-to)628-632
Number of pages5
JournalJournal of Clinical Neuroscience
Volume18
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

Keywords

  • Meningioma
  • Risk factors
  • Surgical outcomes
  • Venous infarction

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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