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Cerebral edema associated with meningiomas.

J J Gilbert, J E Paulseth, R K Coates

    Neurosurgery
    |June 1, 1983
    PubMed
    Summary

    The size of supratentorial meningiomas correlates with the severity of associated cerebral edema. This brain swelling significantly impacts clinical symptoms, similar to edema seen in other brain tumors.

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    Area of Science:

    • Neurology
    • Neurosurgery
    • Pathology

    Background:

    • Supratentorial meningiomas are common primary brain tumors.
    • Cerebral edema is a frequent complication, impacting patient outcomes.
    • Understanding factors influencing edema is crucial for patient management.

    Purpose of the Study:

    • To investigate the relationship between supratentorial meningioma characteristics and associated cerebral edema.
    • To determine if tumor factors predict edema presence and severity.
    • To elucidate the ultrastructural basis of edema in these tumors.

    Main Methods:

    • Computed tomographic (CT) scans were used to assess cerebral edema in 55 patients with supratentorial meningiomas.
    • Tumor characteristics including location, histology, vascularity, cellularity, mitotic figures, necrosis, calcification, and cortical invasion were analyzed.
    • Ultrastructural examination of brain tissue was performed in one case.

    Main Results:

    • No correlation was found between meningioma location, histological type, vascularity, cellularity, mitotic figures, necrosis, calcification, or cortical invasion and the presence or degree of cerebral edema.
    • A significant positive correlation was identified between larger meningioma size and increased likelihood and severity of cerebral edema.
    • Edema was a significant factor in the manifestation of clinical signs and symptoms.
    • Ultrastructural analysis revealed perivascular astrocytic end-feet swelling and extracellular fluid accumulation, resembling vasogenic edema.

    Conclusions:

    • Meningioma size is the primary determinant of associated cerebral edema.
    • Cerebral edema in supratentorial meningiomas contributes significantly to clinical presentation.
    • The ultrastructural findings suggest a vasogenic mechanism for edema in these tumors, similar to other brain pathologies.

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