Two-Staged Approach for Giant Hypervascular Meningioma Resection

Area of Science:

• Neurosurgery
• Oncology

Background:

• Giant meningiomas are rare, hypervascular tumors posing significant surgical challenges.
• High surgical morbidity is associated with traditional resection methods due to complex approaches required for devascularization.

Purpose of the Study:

• To present a two-staged surgical approach for the resection of giant hypervascular meningiomas.
• To evaluate the safety and efficacy of this staged technique in managing these complex tumors.

Main Methods:

• A series of four patients with giant hypervascular meningiomas underwent a two-staged surgical resection between July 2017 and June 2019.
• The first stage involved removal of hypervascular bone, coagulation, and dural excision.
• The second stage, performed 5-8 days later, focused on meningioma excision.

Main Results:

• Simpson's Grade 2 excision was achieved in two patients, and Grade 3 in the other two.
• Three patients were discharged without new neurological deficits.
• One patient with a previously operated malignant meningioma experienced a cardiac event, resulting in mortality.

Conclusions:

• The two-staged approach is a safe and effective surgical strategy for giant meningiomas.
• This method is well-tolerated by patients and offers greater comfort and control for neurosurgeons.