Classification and Protection of Peritumoral Draining Veins of Parasagittal and Falcine Meningiomas

To investigate the importance and types of peritumoral draining veins in parasagittal and falcine meningiomas and administer corresponding protective strategies during surgery according to these different types to improve tumor resection rate and maximize the protection of neurologic functions.

The clinical information of 156 patients with parasagittal and falcine meningiomas who were admitted at the Neurosurgery Department of our hospital was collected and retrospectively analyzed. All patients underwent pathologic classification, magnetic resonance imaging scanning and enhancement, and magnetic resonance venography examinations.

Among these patients, 113 (72.4%) had Simpson grade I and II resection, whereas 43 patients (27.6%) had Simpson grade III and IV resection and underwent postoperative adjuvant gamma knife surgery. Karnofsky Performance Status evaluation was carried out at 1 week after surgery. In total, 69 patients (44.3%) improved, 66 patients (42.3%) had no changes, and 21 patients (13.4%) had worsened conditions (7 patients had hemiplegia, 5 patients had aphasia, 4 patients had decreased vision, and 5 patients had ataxia). There were no deaths. According to the 2016 World Health Organization pathologic grading, 131 patients (84%) were grade I, 22 patients (14%) were grade II, and 3 patients were grade III (2%). Furthermore, 105 patients were followed up for 1-4 years. There were 11 cases of recurrence.

The classification and evaluation of peritumoral draining veins through preoperative-combined magnetic resonance venography can be used as a guide in determining the corresponding protective strategy during surgery. This can significantly improve the tumor resection rate and decrease the postoperative disability rate.