Sahlgrenska Academy, Gothenburg, Sweden.
Institute of Physiology and Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden.
Acta Neurochir (Wien). 2020 Sep;162(9):2155-2163. doi: 10.1007/s00701-020-04244-6. Epub 2020 Feb 3.
Many meningiomas are detected incidentally and remain asymptomatic until intervention. The goal of this study was to describe the management and outcome in this group of surgically treated asymptomatic meningiomas.
From 2004 to 2017, 45 patients with asymptomatic meningioma were surgically treated at Sahlgrenska University Hospital, and their medical records and imaging data were analyzed. The asymptomatic cases were matched with symptomatic ones with respect to age at diagnosis, location, WHO (World Health Organization) grade, and Simpson grade.
Time from diagnosis to surgery differed between the asymptomatic and symptomatic patients (8.6 vs. 1.3 months; p < 0.001). Of symptomatic patients, 32.6% still used anti-epileptic drugs > 1 year after surgery, compared with 7.7% of the asymptomatic (p = 0.003). Thirty-day complication rate was significantly higher among the asymptomatic cases (35.6% vs. 24.4%; 0.001), as well as the proportion of older asymptomatic individuals (> 70 years) experiencing postoperative complication compared with symptomatic patients of the same age group.
As expected, asymptomatic cases had smaller tumors and waited longer for surgery. Surprisingly, complication rate was significantly higher among asymptomatic cases compared with their symptomatic control. Taken into account that many asymptomatic tumors are removed surgically due to patient's wish, one might suggest a more restrictive approach, especially in the elderly.
许多脑膜瘤是偶然发现的，在干预之前没有症状。本研究的目的是描述这组接受手术治疗的无症状脑膜瘤的治疗和结果。
2004 年至 2017 年，在 Sahlgrenska 大学医院对 45 例无症状脑膜瘤患者进行了手术治疗，并对其病历和影像学数据进行了分析。对无症状病例与有症状病例进行了年龄、诊断部位、世界卫生组织（WHO）分级和 Simpson 分级的匹配。
无症状和有症状患者从诊断到手术的时间不同（8.6 个月 vs. 1.3 个月；p<0.001）。在有症状的患者中，32.6%的患者在手术后仍需使用抗癫痫药物>1 年，而无症状患者中这一比例为 7.7%（p=0.003）。无症状病例的 30 天并发症发生率显著高于有症状病例（35.6% vs. 24.4%；p=0.001），且无症状病例中年龄较大（>70 岁）的患者发生术后并发症的比例高于同年龄组的有症状患者。
正如预期的那样，无症状病例的肿瘤较小，手术等待时间也较长。令人惊讶的是，无症状病例的并发症发生率明显高于有症状病例。考虑到许多无症状肿瘤是由于患者的意愿而被手术切除的，人们可能会建议采取更严格的方法，尤其是对老年人。
