Division of Neurosurgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via F. Sforza, 35, 20122, Milan, Italy.
Division of Neurosurgery, Azienda Ospedaliero Universitaria - Ospedale Maggiore della Carità di Novara, Novara, Italy.
J Neurooncol. 2018 May;137(3):611-619. doi: 10.1007/s11060-018-2754-3. Epub 2018 Jan 12.
Surgical treatment of elderly patients with meningioma is has proved to be safe, especially when patients are selected using dedicated surgical scores. These scores take into account tumor size, edema, location and patient's co-morbidities. Neuropsychological functioning (NPF) of this kind of patients has been poorly studied in literature and it is not taken into account by these scores. Aim of our study was to describe the long-term outcome in terms of NPF of elderly patients undergoing surgery. Patients older than 70 years of age affected by intracranial meningioma and selected with the Clinical-Radiological Grading Score were included in our study. Neuropsychological testing was performed using a dedicated battery of tests before surgery, 3 and 12 months after surgery. Clinical, neurological and radiological outcomes were studied as well. Forty-one patients with a median age of 74 years were included in this study. Preoperatively only 1/41 patients showed a normal NPF with all tests scoring normally. Four out of 39 patients showed a complete neuropsychological recovery after 3 months; while 10/37 patients had a complete recovery after 12 months. NPF showed a trend of progressive improvement after surgery. Our study is the first experience reported in literature describing a long term follow-up in elderly patients after surgery for intracranial meningioma. In our series, surgery determined an improvement of NPF over time; especially with a low complication rate related to the selection of patients obtained through the CRGS. Further studies need to be performed in order to understand how brain edema, tumor size, volume and tumor location affect NPF in both short and long term.
手术治疗老年脑膜瘤患者已被证明是安全的，尤其是当使用专门的手术评分选择患者时。这些评分考虑了肿瘤大小、水肿、位置和患者的合并症。文献中对这类患者的神经心理学功能（NPF）研究甚少，这些评分也没有考虑到这一点。我们的研究目的是描述接受手术的老年患者的 NPF 长期预后。本研究纳入了年龄大于 70 岁、患有颅内脑膜瘤且经临床-放射分级评分选择的患者。在手术前、手术后 3 个月和 12 个月使用专门的测试电池进行神经心理学测试。还研究了临床、神经和放射学结果。本研究共纳入 41 例患者，中位年龄为 74 岁。术前仅有 1/41 例患者 NPF 正常，所有测试均正常。39 例中有 4 例在 3 个月后完全恢复神经心理学功能；而 37 例中有 10 例在 12 个月后完全恢复。NPF 在手术后呈逐渐改善的趋势。我们的研究是文献中首次报道的对颅内脑膜瘤手术后老年患者进行长期随访的经验。在我们的系列研究中，手术随着时间的推移提高了 NPF；特别是在通过 CRGS 选择患者的情况下，并发症发生率相对较低。需要进一步研究以了解脑水肿、肿瘤大小、体积和肿瘤位置如何在短期和长期内影响 NPF。
