Surgical Management of Giant Intracranial Meningiomas

Abstract

Objective: Giant intracranial meningiomas are a challenge for neurosurgeons because of their size and location in the cranium. Difficult tumor dissection and encasement of important neurovascular structures makethem a horrible nightmare. The aims of this study are to present our giant intracranial meningioma series andto compare our experience using advanced surgical technology with the current literature.Materials and Methods: The data of patients with the diagnosis of giant intracranial meningioma between2014 and 2020 who underwent surgical treatment were retrospectively reviewed. The demographic, radiological, and surgical characteristics of patients were documented. The size and location of tumors as well assurgical technique were analyzed in detail.Results: A total of 61 patients with intracranial meningioma underwent surgical treatment over a 7-yearperiod, and 10 (16.4%) tumors were larger than 5 cm in diameter, which were classified as giant meningioma.Seven patients were male and 3 were female, with a mean age of 64.9 years. Four tumors were located at theskull base. Histological diagnosis was meningioma World Health Organization grade I in 7 patients and gradeII in 3 patients. Simpson grade 1 resection was achieved in 6 patients and grade 2 resection in 4 patients. Nomortality was observed.Conclusion: Careful surgical planning should be made for giant intracranial meningiomas. Their location, adjacent neurovascular structures, and vascular supply affect the resection level of these giant tumors. Simpsongrade 1 resection is seldom possible for skull base meningiomas.