Summary
Meningiomas were studied in 60 patients retrospectively. Clinical, operative and histological findings were correlated with the occurrence and extension of peritumoural oedema as measured by computerized tomography. A relationship was found between both oedema and seizures and between oedema and tumour location. No relationship between tumour size, arachnoid breaching, WHO-grade or tumour vascularity and oedema was detected. In four patients with severe pre-operative oedema, cerebral signs and symptoms persisted despite uncomplicated tumour removal.
The present study shows that peritumoural oedema is not only epileptogenic but that it can also cause irreversible cerebral damage as well. Since this study purports to demonstrate that meningiomas with intact leptomeninges can show severe peritumoural oedema, the blood barrier breakdown theory cannot be considered as the only aetiological factor.
Similar content being viewed by others
References
Aaslid R, Groger U, Patlak CS, Fenstermacher JD, Huber P Reulen HJ (1990) Fluid flow rates in human peritumoural oedema. Acta Neurochir (Wien) [Suppl] 51: 152–154
Baethmann A, Oettinger W, Rothenfusser, Kempski O, Unterberg A, Geiger R (1980) Brain edema factors: current state with particular reference to plasma constituents and glutamate. In: Cervos-Navarro J, Ferszt R (eds) Advances in neurology, Vol 28: brain oedema. Raven, New York, pp 171–195
Bradac GB (1976) Some aspects fo the venous drainage dynamics with tumours at the base of the skull in the anterior and middle fossae. Neuroradiology 12: 115–120
Bradac GB, Ferszt R, Bender A, Schorner W (1986) Peritumoral edema in meningiomas. Neuroradiology 28: 304–312
Bradac GB, Ferszt R, Kendall BE, Stevens J (1990) Peritumoral oedema in meningiomas. In: Bradac GB, Ferszt R, Kendall BE (eds) Cranial meningiomas. Springer, Berlin Heidelberg New York Tokyo, pp 120–128
Challa VR, Moody DM, Marshall RB, Kelly Jr DL (1980) The vascular component in meningiomas associated with severe cerebral edema. Neurosurgery 7: 363–368
Ciric I (1988) Comments. In: Trittmacher S, Traupe, Schmid A (eds) Pre- and postoperative changes in brain tissue surrounding a meningioma. Neurosugery 22: 882–885
Crone KR, Challa VR, Kute TE, Moody DM, Kelly DL (1988) Relationship between flow cytometric features and clinical behavior of meningiomas. Neurosurgery 23: 720–724
Drape JL, Krause D, Tongio J (1992) MRI of aggressive meningiomas. J. Neuroradiol. 19: 49–62
Fine M, Brazis P, Palacois E, Neri G (1980) Computed tomography of sphenoid wing meningiomas: tumor location related to distal edema. Surg Neurol 13: 385–390
Gaetani P, Rodriguez y Baena R, Marzatico F, Lombardi D, Knerich R, Paoletti P (1991) “Ex vivo” release of eicosanoid from human brain tissue: its relevance in the development of brain edema. Neurosurgery 28: 853–858
Gilbert JJ, Paulseth JE, Coates RK, Malott D (1983) Cerebral edema associated with meningiomas. Neurosurgery 12: 599–605
Go GK, Wilmink JT, Molenaar WM (1988) Peritumoral brain edema associated with meningiomas. Neurosurgery 23: 175–179
Hashimoto T, Ikehira H, Fukuda H, Yamaura A, Watanabe O, Tateno Y, Tanaka R, Simon HE (1991) In vivo sodium-23 MRI in brain tumors: evaluation of preliminary clinical experience. Am J Physiol Imaging 6: 74–80
Ikeda Y, Long DM (1990) Oxygen free radicals in the genesis of peritumoural oedema in experimental malignant brain tumours. Acta Neurochir (Wien) [Suppl] 51: 142–144
Iwama T, Yamada H, Era S, Sogami M, Andoh T, Sakai N, Kato K, Kuwata K, Watari H (1992) Proton nuclear magnetic resonance studies on water structure in peritumoral edematous brain tissue. Magn Reson Med 24: 53–63
Lindley JG, Challa VR, Kelly DL (1991) Meningiomas and brain edema. In: Al-Mefty O (ed) Meningiomas. Raven, New York, pp 59–73
Long DM (1981) Comments. In: Smith HP, Challa VR, Moody DM, Kelly DL (eds) Biological features of meningiomas that determine the production of cerebral edema. Neurosurgery 8: 428–433
Marmarou A, Takagi H, Shulmann K (1980) Biomechanics of brain edema and effects on local cerebral blood flow. In: CervosNavarro J, Ferszt R (eds) Advances in neurology, Vol 28: brain oedema. Raven, New York, pp 345–358
Ohnishi T, Sher PB, Posner JB, Shapiro WR (1991) Increased capillary permeability in rat brain induced by factors secreted by cultured C 6 glioma cells: role in peritumoral brain edema. J Neurooncol 10: 13–15
Penn RD (1980) Cerebral edema and neurological function: CT evoked responses, and clinical examination. In: Cervos-Navarro J, Ferszt R (eds) Advances in neurology, Vol 28: brain oedema. Raven, New York, pp 383–394
Philippon J, Foncin JF, Grob R, Srour A, Poisson M, Pertuiset BF (1984) Cerebral edema associated with meningiomas: possible role of a secretory-excretory phenomenon. Neurosurgery 14: 295–301
Reulen H-J, Graber S, Huber P, Ito U (1988) Factors affecting the extension of peritumoural brain oedema. A CT-study. Acta Neurochir (Wien) 95: 19–24
Sawaya R, Ramo JO, Lin Shi M, Mandybur G (1991) Biological significance of tissue plasminogen activator content in brain tumors. J Neurosurg 74: 480–486
Smith HP, Challa VR, Moody DM, Kelly DL (1981) Biological features of meningiomas that determine the production of cerebral edema. Neurosurgery 8: 428–433
Steen RG (1992) Edema and tumor perfusion. Characterization by quantitative 1 H MR imaging. AJR 158-259-264
Stevens JM, Ruiz JS, Kendall BE (1983) Observations on peritumoural oedema in meningioma: Part 1: distribution, spread and resolution of vasogenic oedema seen on computed tomography. Neuroradiology 25: 71–80
Stevens JM, Ruiz JS, Kendall BE (1983) Observations on peritumoural oedema in meningioma. Part 2: mechanisms of oedema production. Neuroradiology 25: 125–131
Sutton LN, Bruce DA, Welsh FA, Jaggi JL (1980) Metabolic and electrophysiologic consequences of vasogenic edema. In: Cervos-Navarro J, Ferszt R (eds) Advances in neurology, Vol 28: brain oedema. Raven, New York, pp 241–254
Trittmacher S, Traupe H, Schmid A (1988) Pre- and postoperative changes in brain tissue surrounding a meningioma. Neurosurgery 22: 882–885
Vassilouthis J, Ambrose J (1979) Computerized tomography scanning appearances of intracranial meningiomas. J Neurosurg 50: 320–327
Whittle IR, Piper IR, Miller JD (1990) The contribution of secondary mediators to the etiology and pathophysiology of brain oedema: studies using a feline infusion model. Acta Neurochir (Wien) [Suppl] 51: 71–73
Zülch KJ (1979) Histological typing of tumours of the central nervous system. WHO, Geneva
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
de Vries, J., Wakhloo, A.K. Cerebral oedema associated with WHO-I, WHO-II, and WHO-III-meningiomas: Correlation of clinical, computed tomographic, operative and histological findings. Acta neurochir 125, 34–40 (1993). https://doi.org/10.1007/BF01401825
Issue Date:
DOI: https://doi.org/10.1007/BF01401825