Complications of first craniotomy for intra-axial brain tumour.

Complications were examined in a single surgeon's series of 207 consecutive adult patients undergoing first craniotomy for intra-axial brain tumour. The study group consisted of 114 gliomas, 74 metastatic tumours and 19 miscellaneous lesions. There were 25 infratentorial tumours and 182 supratentorial tumours (39 deep and 143 superficial). The total number of patients sustaining complications was 52 for an overall complication rate of 25.1%; the rate was higher for infratentorial tumours (44.0%) than supratentorial tumours (22.8%) regardless of histology (p = 0.012). There were 5 deaths for a mortality rate of 2.4%. Forty-seven patients incurred operative morbidity (22.7%); 7 out of the 47 had multiple complications. Sixteen patients sustained transient worsening due to edema (7.7%) and 6 patients sustained permanent neurological deficit (2.9%). Medical complications were suffered by 17 patients (8.2%). Major complications which significantly altered the quality and/or quantity of survival were suffered by 9 patients overall (4.3%).