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A Visual Description of the Dissection of the Cerebral Surface Vasculature and Associated Meninges and the Choroid Plexus from Rat Brain
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Vascularity of meningiomas
Shaheryar F Ansari1, Kushal J Shah2, Wael Hassaneen3
1Department of Neurological Surgery, Indiana University, Indianapolis, IN, United States.
Handbook of Clinical Neurology
|June 20, 2020
Summary
Understanding meningioma vascularity is key for surgeons. Higher vascularity correlates with increased recurrence risk and vascular endothelial growth factor (VEGF) levels, impacting treatment strategies.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Meningiomas, tumors of the meninges, rely on vascular supply for growth, primarily from the external carotid artery.
- Angiogenesis, stimulated by factors like vascular endothelial growth factor (VEGF), is crucial for meningioma development.
- Peritumoral brain edema (PTBE) complicates surgical resection, with its exact cause still under investigation.
Purpose of the Study:
- To review the critical information regarding the vascular supply of meningiomas.
- To discuss the role of angiogenesis and VEGF in meningioma growth.
- To explore the challenges posed by PTBE and the utility of embolization.
Main Methods:
- Review of current literature on meningioma vascularity, angiogenesis, and PTBE.
- Discussion of diagnostic imaging techniques, including angiography and noninvasive methods.
- Analysis of the relationship between tumor grade, vascularity, VEGF levels, and recurrence.
Main Results:
- Most meningiomas receive supply from the external carotid artery, with potential pial contributions.
- Higher vascularity in meningiomas is associated with higher tumor grade, increased VEGF levels, and a greater likelihood of recurrence.
- While embolization can reduce blood loss, its impact on outcomes and associated risks are noted.
Conclusions:
- Vascular supply characteristics are vital for neurosurgical planning and understanding meningioma behavior.
- VEGF inhibition is a potential therapeutic target for managing meningioma angiogenesis.
- Further research into meningioma vascularity is ongoing and essential for improving patient outcomes.
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