Variability in the Arterial Supply of Intracranial Meningiomas: An Anatomic Study

被引:2
作者
Ahmed, Abdul-Kareem [1 ,5 ]
Wilhelmy Jr, Bradley [2 ]
Oliver, Jeffrey [1 ]
Serra, Riccardo [1 ]
Chen, Chixiang [1 ]
Gandhi, Dheeraj [1 ,3 ,4 ]
Eisenberg, Howard M. [1 ]
Labib, Mohamed A. [1 ]
Woodworth, Graeme F. [1 ]
机构
[1] Univ Maryland, Dept Neurosurg, Sch Med, Baltimore, MD USA
[2] Univ Maryland, Dept Neurosurg, Sch Med, Baltimore, MD USA
[3] Univ Maryland, Dept Diagnost Radiol & Nucl Med, Sch Med, Baltimore, MD USA
[4] Univ Maryland, Dept Neurol, Sch Med, Baltimore, MD USA
[5] Univ Maryland, Sch Med, Dept Neurosurg, 22 S Greene St,Suite 12D, Baltimore, MD 21201 USA
关键词
Meningioma; Vascularity; Tumor grade; Seizure; BRAIN-TUMORS; GRADE; CLASSIFICATION; SEIZURES; LOCATION; CELL;
D O I
10.1227/neu.0000000000002608
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND OBJECTIVES: Intracranial meningiomas are a diverse group of tumors, which vary by grade, genetic composition, location, and vasculature. Expanding the understanding of the supply of skull base (SBMs) and nonskull base meningiomas (NSBMs) will serve to further inform resection strategies. We sought to delineate the vascular supply of a series of intracranial meningiomas by tumor location. METHODS: A retrospective study of intracranial meningiomas that were studied using preoperative digital subtraction angiograms before surgical resection at a tertiary referral center was performed. Patient, tumor, radiologic, and treatment data were collected, and regression models were developed. RESULTS: One hundred sixty-five patients met inclusion criteria. The mean age was 57.1 years (SD: 12.6). The mean tumor diameter was 4.9 cm (SD: 1.5). One hundred twenty-six were World Health Organization Grade I, 37 Grade II, and 2 Grade III. Arterial feeders were tabulated by Al-Mefty's anatomic designations. SBMs were more likely to derive arterial supply from the anterior circulation, whereas NSBMs were supplied by external carotid branches. NSBMs were larger (5.61 cm vs 4.45 cm, P = <.001), were more often presented with seizure (20% vs 8%, P = .03), were higher grade (P = <.001) had more frequent peritumoral brain edema (84.6% vs 66%, P = .04), and had more bilateral feeders (47.7% vs 28%, P = .01) compared with SBMs. More arterial feeders were significantly associated with lower tumor grade (P = .023, OR = 0.59). Higher tumor grade (Grade II/III) was associated with fewer arterial feeders (P = .017, RR = 0.74). CONCLUSION: Meningioma location is associated with specific vascular supply patterns, grade, and patient outcomes. This information suggests that grade I tumors, especially larger tumors, are more likely to have diverse vascular supply patterns, including internal carotid branches. This study may inform preoperative embolization and surgical considerations, particularly for large skull base tumors. (C) Congress of Neurological Surgeons 2023. All rights reserved.
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收藏
页码:1346 / 1352
页数:7
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