Intracranial Meningiomas – Criteria for Selection of the Optimum Therapeutic Modality

Czech version

Authors: P. Kozler ¹; F. Kramář ¹; V. Beneš ¹; F. Charvát ²
Authors‘ workplace: Neurochirurgická klinika 1. LF UK a ÚVN, Subkatedra neurochirurgie IPVZ Praha přednosta plk. prof. MUDr. V. Beneš, DrSc. ¹; Radiodiagnostické oddělení ÚVN Praha, přednosta pplk. MUDr. F. Charvát ²
Published in: Rozhl. Chir., 2005, roč. 84, č. 8, s. 383-391.
Category: Monothematic special - Original

Overview

The authors present their own proposal for a standard diagnostic procedure algorithm in intracranial meningiomas, which they used in their prospective, non-randomized longitudinal study in a group of 30 subjects within a year. The following four criteria were assessed in each patient: age, physical condition according the ASA classification, location of the meningioma on the MRI (superficial, the scull base) and the growth invasivity using selective DSA (ACI+ACE) and MRI (the vascularization type, the oedema index and the change in the oedema signal intensity in 3.5 hours). The criteria helped to establish the optimum therapeutic procedure for each patient: embolisation without a follow-up surgery (2 subjects), observation (2 subjects), pre-operative embolisation (5 subjects) and surgery without preceeding embolisation (21 subjects). This study did not assess the intracranial meningiomas treatment outcome. It highlights significance of the diagnostic procedures standardization in order to establish their optimum therapeutic modality.

Key words:
intracranial meningioma – ASA – growth invasivity – embolisation – MRI – selective DSA