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Management of intracranial meningiomas in Enugu, Nigeria

BACKGROUND: Meningiomas may range on presentation from incidentally identified small lesions to large symptomatic tumors in eloquent areas of the brain. Management options correspondingly vary and include careful observation, surgical excision, and palliative application of very limited therapeutic...

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Autores principales: Mezue, Wilfred C, Ohaegbulam, Samuel C, Ndubuisi, Chikandu A, Chikani, Mark C., Achebe, David S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475883/
https://www.ncbi.nlm.nih.gov/pubmed/23087826
http://dx.doi.org/10.4103/2152-7806.101788
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author Mezue, Wilfred C
Ohaegbulam, Samuel C
Ndubuisi, Chikandu A
Chikani, Mark C.
Achebe, David S
author_facet Mezue, Wilfred C
Ohaegbulam, Samuel C
Ndubuisi, Chikandu A
Chikani, Mark C.
Achebe, David S
author_sort Mezue, Wilfred C
collection PubMed
description BACKGROUND: Meningiomas may range on presentation from incidentally identified small lesions to large symptomatic tumors in eloquent areas of the brain. Management options correspondingly vary and include careful observation, surgical excision, and palliative application of very limited therapeutic maneuvers in select cases. This paper discusses the options and difficulties in the management of meningiomas in a developing country. METHODS: This study is a retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2006 and September 2011 at Memfys Hospital for Neurosurgery, Enugu. Radiographic diagnosis of meningioma was based on computed tomography (CT) and or magnetic resonance imaging (MRI) criteria in all cases, but only patients who had surgery and a histological diagnosis were analyzed. RESULTS: Seventy-four patients were radiographically diagnosed with intracranial meningioma over the period under review. Fifty-five patients were operated upon and 52 (70.3%) with histological diagnosis of meningioma were further analyzed. Histological diagnosis was complete in 42 (56.8%) patients and in 10 (13.5%) patients the subtype of meningioma was not determined. The male to female ratio was 1:1.08. The peak age range for females was in the 6th decade and for males in the 5th decade. The locations were olfactory groove (26.9%), convexity (21.2%), parasagittal/falx (19.2%), sphenoid ridge (15.4%), tuberculum sellae (7.7%), tentorial (3.8%), and posterior fossa (5.8%). The most common clinical presentation was headaches in 67.3% followed by seizures (40.4%) and visual impairment (38.5%). Histology was benign (World Health Organization [WHO] grade 1) in 39 patients. One patient harbored an atypical and two had anaplastic tumors. Gross total resection of the tumor was achieved in 41 patients. Surgical mortality was 3.9%. CONCLUSION: Effective management of meningioma depends largely on adequate and complete surgical resection and results in good outcomes. Adequate preoperative assessment, including visual assessment, and hormonal assessment in olfactory groove and sphenoid region meningiomas, is necessary.
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spelling pubmed-34758832012-10-19 Management of intracranial meningiomas in Enugu, Nigeria Mezue, Wilfred C Ohaegbulam, Samuel C Ndubuisi, Chikandu A Chikani, Mark C. Achebe, David S Surg Neurol Int Original Article BACKGROUND: Meningiomas may range on presentation from incidentally identified small lesions to large symptomatic tumors in eloquent areas of the brain. Management options correspondingly vary and include careful observation, surgical excision, and palliative application of very limited therapeutic maneuvers in select cases. This paper discusses the options and difficulties in the management of meningiomas in a developing country. METHODS: This study is a retrospective analysis of prospectively recorded data of patients managed for intracranial meningioma between January 2006 and September 2011 at Memfys Hospital for Neurosurgery, Enugu. Radiographic diagnosis of meningioma was based on computed tomography (CT) and or magnetic resonance imaging (MRI) criteria in all cases, but only patients who had surgery and a histological diagnosis were analyzed. RESULTS: Seventy-four patients were radiographically diagnosed with intracranial meningioma over the period under review. Fifty-five patients were operated upon and 52 (70.3%) with histological diagnosis of meningioma were further analyzed. Histological diagnosis was complete in 42 (56.8%) patients and in 10 (13.5%) patients the subtype of meningioma was not determined. The male to female ratio was 1:1.08. The peak age range for females was in the 6th decade and for males in the 5th decade. The locations were olfactory groove (26.9%), convexity (21.2%), parasagittal/falx (19.2%), sphenoid ridge (15.4%), tuberculum sellae (7.7%), tentorial (3.8%), and posterior fossa (5.8%). The most common clinical presentation was headaches in 67.3% followed by seizures (40.4%) and visual impairment (38.5%). Histology was benign (World Health Organization [WHO] grade 1) in 39 patients. One patient harbored an atypical and two had anaplastic tumors. Gross total resection of the tumor was achieved in 41 patients. Surgical mortality was 3.9%. CONCLUSION: Effective management of meningioma depends largely on adequate and complete surgical resection and results in good outcomes. Adequate preoperative assessment, including visual assessment, and hormonal assessment in olfactory groove and sphenoid region meningiomas, is necessary. Medknow Publications & Media Pvt Ltd 2012-09-28 /pmc/articles/PMC3475883/ /pubmed/23087826 http://dx.doi.org/10.4103/2152-7806.101788 Text en Copyright: © 2012 Mezue WC. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Mezue, Wilfred C
Ohaegbulam, Samuel C
Ndubuisi, Chikandu A
Chikani, Mark C.
Achebe, David S
Management of intracranial meningiomas in Enugu, Nigeria
title Management of intracranial meningiomas in Enugu, Nigeria
title_full Management of intracranial meningiomas in Enugu, Nigeria
title_fullStr Management of intracranial meningiomas in Enugu, Nigeria
title_full_unstemmed Management of intracranial meningiomas in Enugu, Nigeria
title_short Management of intracranial meningiomas in Enugu, Nigeria
title_sort management of intracranial meningiomas in enugu, nigeria
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475883/
https://www.ncbi.nlm.nih.gov/pubmed/23087826
http://dx.doi.org/10.4103/2152-7806.101788
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