Angiographic findings in recurrent meningioma.

Of 147 patients who underwent radical surgery for intracranial meningioma, 25 (17%) had symptomatic recurrence requiring further surgery. Correlation between histological and angiographic findings of recurrent meningioma was poor. Following extirpation of feeding meningeal vessels in convexity meningiomas, the principal blood supply was usually from the anterior, middle, and/or posterior cerebral arteries. The angiographic appearance was that of a "tree-root" or "sunburst" pattern, indicating neoplastic invasion of the pia mater and/or underlying brain tissue. Polytomography, selective cerebral angiography, and radionuclide imaging of the brain are often necessary to detect early recurrent meningiomas. Computed tomography appears to be an innocuous and accurate method of diagnosing recurrent tumor, especially when the bone is not involved.