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Updated: May 21, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Predictive factors related to symptomatic venous infarction after meningioma surgery
Woo-Youl Jang1, Shin Jung, Tae-Young Jung
1Department of Neurosurgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Gwangju, South Korea.
Introduction:
The incidence of venous infarction after surgical resection of meningioma is low, but its occurrence can necessitate additional surgical procedures and long hospital stay. In this study, we evaluated variables associated with venous infarction after meningioma surgery.
Methods:
Among 825 patients with intracranial meningiomas who underwent microsurgical resection between January 1993 and March 2011, 27 (3.3%) presented with neurological deterioration due to postoperative venous infarction. The following factors were included in the statistical analysis to determine their association with venous infarction: sex, age, location, relation to venous sinus, peritumoural oedema, size and degree of resection.
Results:
Incidence of venous infarction was 6.8% with large meningiomas (size ≥ 4 cm), but with small (size < 4 cm) was reduced to 1.2% (p < 0.001). Meningiomas with perilesional edema elicited venous infarction more frequently than those without (5.1% vs. 2.3%, p = 0.030). Venous infarction was also determined to occur at 5.5% frequency in superficial meningiomas, such as parasagittal, falx and convexity, but only at 0.5% frequency in deep locations (p = 0.001). Venous infarction additionally occurred less often in meningiomas at a distance from the midline venous sinus than in those nearby, such as parasagittal and falx (2.2% vs. 6.6%, p = 0.004).
Conclusions:
To prevent venous infarction after meningioma surgery, it is essential to maintain the intervening arachnoid plane as much as possible; this is especially important in meningiomas larger than 4 cm, combined with peritumoural edema or positioned superficially around the midline venous sinus.
Insights
Venous infarction after meningioma surgery is linked to tumor size, edema, and location. Larger tumors (>4cm), peritumoral edema, and superficial locations increase risk, necessitating careful surgical technique.
Area of Science:
- Neurosurgery
- Neurology
- Oncology
Background:
- Venous infarction post-meningioma resection is infrequent but serious.
- It can lead to further surgeries and prolonged hospital stays.
Purpose of the Study:
- To identify factors associated with venous infarction after meningioma surgery.
- To inform strategies for preventing this complication.
Main Methods:
- Retrospective analysis of 825 patients undergoing intracranial meningioma resection.
- Statistical evaluation of variables including sex, age, tumor size, location, peritumoral edema, and venous sinus proximity.
Main Results:
- Incidence of venous infarction was significantly higher for large meningiomas (≥4 cm) (6.8%) versus small (<4 cm) (1.2%).
- Peritumoral edema (5.1% vs. 2.3%) and superficial locations (parasagittal, falx, convexity) (5.5% vs. 0.5%) were associated with increased risk.
- Proximity to midline venous sinuses also correlated with higher incidence (6.6% vs. 2.2%).
Conclusions:
- Maintaining the arachnoid plane during surgery is crucial for prevention.
- Particular vigilance is needed for large, superficially located meningiomas with peritumoral edema near venous sinuses.
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