Article
Which are independent risk factors for pre- and postoperative seizures in meningioma patients? Results from a large single-center study
Risikofaktoren für das Auftreten von prä- und postoperativen Krampfanfällen bei Patienten mit intrakraniellen Meningeomen
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Published: | May 8, 2019 |
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Objective: Seizures are a common presenting symptom of intracranial lesions and a well-known complication of meningioma surgery. We performed univariate and multivariate analyses to identify independent patient- and tumor-specific risk factors of pre- and postoperative seizures in meningioma patients.
Methods: We retrospectively analyzed consecutive patients that underwent surgical resection of intracranial meningioma at our institution between 2004 and 2017. We retrospectively collected patient demographics, tumor characteristics and procedural specifics from the medical charts. Factors predictive in the univariate analysis (p<0.05) were entered into a stepwise binary logistic regression model to identify independent risk factors of pre- and postoperative seizures. All calculations were performed using SPSS Version 25 (IBM, Armonk, NY, USA). A p-value <0.05 was considered as statistically significant.
Results: A total of 729 patients were treated during the study period. The rates for pre- and postoperative seizures were 18.9% and 10.0%, respectively. In the univariate analysis, preoperative seizures were associated with male gender (p=0.01), preoperative motor deficits (p<0.01) and peritumoral edema (p<0.01). Headache (p<0.01), preoperative sensoric symptoms (p<0.01) and occipital tumor location (p=0.02) were negatively correlated with preoperative seizures. Preoperative motor deficits (p<0.01, OR: 3.9, 95% CI: 2.6–5.9) and peritumoral edema (p<0.01, OR: 3.5, 95% CI: 1.8–6.7) were independent risk factors of preoperative seizures in the multivariate analysis.
Risk factors for postoperative seizures were parietal tumor location (p=0.02), WHO grades 2 and 3 (p<0.01), presence of multiple meningiomas (p=0.03), incomplete tumor resection (Simpson grade >3, p=0.07) and recurrent meningioma (p=0.01). In the multivariate analysis, incomplete resection (p=0.04, OR: 2.6, 95% CI: 1.1–6.6) and recurrent meningioma (p=0.04, OR: 2.6, 95% CI=1.1–6.2) were independently associated with postoperative seizures.
Conclusion: Peritumoral edema and preoperative motor deficits represent independent risk factors for preoperative seizures. Incomplete tumor resection and recurrent meningioma are independently associated with postoperative seizures.