Bommakanti Kalyan, Somayajula Shanmukhi, Suvarna Alladi, Purohit Aniruddh Kumar, Mekala Shailaja, Chadalawadi Santoshi Kumari, Gaddamanugu Padmaja
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Department of Neurology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Clin Neurol Neurosurg. 2016 Apr;143:150-8. doi: 10.1016/j.clineuro.2016.02.033. Epub 2016 Feb 26.
Cognitive deficits caused by extra-axial benign brain tumors like meningiomas and the course of these deficits after surgery is not well known. The aim of the study is to assess the pre-operative and post-operative cognitive functions in patients with meningiomas in the supratentorial compartment.
In this prospective study, patients with clinico-radiological diagnosis of supratentorial meningioma, operated upon and later confirmed by histopathological examination, were included. The patients were evaluated for cognitive deficits before and after surgery. The various clinical and radiological factors influencing the cognitive status were evaluated.
A total of 57 patients were enrolled into the study. Out of 57, 22 were males and 35 were females. The frontal group had 22 patients, the parietal group had 10 patients, the temporal group had 10 patients, the occipital group had 6 patients, and the suprasellar group had 9 patients. Meningiomas, although extra-axial, caused significant cognitive deficits in 42 patients (73.7%). The highest frequency of cognitive deficits is seen in the frontal and temporal group of meningiomas (90% each). Frontal meningiomas with volume greater than 35 cc and peritumoral edema greater than 40 cc caused a higher frequency of cognitive deficits. Also, patients with raised ICP had significant cognitive deficits. Postoperatively there was a significant improvement in the cognitive functions in the frontal and temporal groups.
Meningiomas cause cognitive deficits in 73.7% of patients. Anatomical location of meningioma, elevated ICP, the volume of meningioma and extent of peritumoral edema significantly influence the incidence of cognitive deficits. Post-operatively, the cognitive deficits improve significantly in the frontal and temporal group.
像脑膜瘤这类颅外良性脑肿瘤所导致的认知缺陷以及手术后这些缺陷的病程尚不清楚。本研究的目的是评估幕上脑膜瘤患者术前和术后的认知功能。
在这项前瞻性研究中，纳入了经临床放射学诊断为幕上脑膜瘤、接受手术治疗并随后经组织病理学检查确诊的患者。对患者在手术前后进行认知缺陷评估。评估了影响认知状态的各种临床和放射学因素。
共有57例患者纳入本研究。57例中，男性22例，女性35例。额叶组有22例患者，顶叶组有10例患者，颞叶组有10例患者，枕叶组有6例患者，鞍上组有9例患者。脑膜瘤虽为颅外肿瘤，但在42例患者（73.7%）中导致了显著的认知缺陷。认知缺陷发生率最高的是额叶和颞叶脑膜瘤组（均为90%）。体积大于35立方厘米且瘤周水肿大于40立方厘米的额叶脑膜瘤导致认知缺陷的频率更高。此外，颅内压升高的患者存在显著的认知缺陷。术后额叶和颞叶组的认知功能有显著改善。
73.7%的患者因脑膜瘤出现认知缺陷。脑膜瘤的解剖位置、颅内压升高、脑膜瘤体积和瘤周水肿程度显著影响认知缺陷的发生率。术后，额叶和颞叶组的认知缺陷有显著改善。
