Author/Editor		Bošnjak, Roman; Derham, Christopher; Popović, Mara; Ravnik, Janez
Title		Spontaneous intracranial meningioma bleeding: clinicopathological features and outcome
Type		članek
Source		J Neurosurg
Vol. and No.		Letnik 103, št. 3
Publication year		2005
Volume		str. 473-84
Language		eng
Abstract		Object. The aim of this study was to determine the clinicopathological features of patients with intracranial bleeding from unsunspected meningioma and to relate these data to surgery-related outcome. Methods. The authors report on two cases in which hemorrhage of an unsuspected meningioma occurred in the tentorial ridge and in the falx, and they discuss the details of 143 cases described in the literature. A bleeding propensity index of the meningioma, related to the patients age, sex, and the lesions intracranial location and histological type was computed as a ratio between the frequencies of bleeding meningioma all meningiomas. This was tested by independent samples t-test for proportions. A chi-square test was used to determine the corelations between several variables: location and type of bleeding; survival and type of bleeding; and consciousness and survival. Increased bleeding tendency was found to be associated with two age groups (<30 years and >70 years), convexity and intraventricular locations, and fibrous meningiomas. The overall mortality rate documented in cases of bleeding meningiomas was 21.1% (13.9% in the computerized tomography (CT) scanning era, and that in surgically treated cases was 9.5% (7.5% in the CT scanning era). The overall major morbidity rate was 36% (33.8% in the CTscanning era). Overall 96.2% of conscious patients survived after their meningiomas spontaneously hemorrhaged. In patients who were inconscious before surgery, overall mortality rate was 74.1%, and that in surgically treated cases was 46.2%. Conclusions. The mortality rate in preoperatively conscious patients (those in whom acute deterioration and irreversible brain damage were prevented by early diagnosis and definitive surgery) was similar (<3% in the CT scanning era) to that documented in cases in which meningiomas did not bleed. (Abstract truncated at 2000 characters)
Descriptors		MENINGIOMA MENINGEAL NEOPLASMS CEREBRAL HEMORRHAGE CONSCIOUSNESS PROGNOSIS AGE FACTORS SEX FACTORS SURVIVAL RATE RISK FACTORS RETROSPECTIVE STUDIES