Summary
Context : meningiomas are generally slow -growing intracranial tumors. They are often diagnosed fortuitously, since the symptoms can be absent even in the case of a tumor of enormous size. Headaches are a frequent but non -constant symptom. This is why we have examined the association between the structural, biochemical and histochemical parameters of the tumor and the preoperative and postoperative appearance of the headache.
Methods : In our study, we have prospectively studied 69 consecutive patients registered in meningioma neurosurgery . The anatomical, histological and biochemical parameters have been acquired, and the parameters of the headache were recorded from the clinical ratio and a questionnaire filled by patients before neurosurgery. The headache was reassessed a year after neurosurgery. The study was designed to examine exploratory if there is an association between the acquired clinical and biological parameters and the appearance of preoperative and postoperative headaches.
Results : The diameter of the edema and the MIB-1 proliferation marker were associated negatively with the impact and intensity of preoperative headaches, while the E2 prostaglandin content of the tumor tissue was positively associated with the intensity of preoperative headaches. The headache was more frequent when the meningioma was located in the area supplied by the ophthalmic trigenic branch. Compared to preoperative headache levels, a global reduction was observed one year after the operation, and patients with a larger tumor experienced a greater remission of headache. In parietal and occipital meningiomas and in those with greater edema, the percentage of the capphalé remission rate was higher compared to other locations or smaller edema. Multivariable analyzes have shown an involvement of the P and the Prostaglandine E2 in preoperative headaches.
Conclusions : The study demonstrates new associations between meningiomas and headache . The result of postoperative headache in the sample of patients presented is encouraging for the neurosurgical intervention carried out. These results should be tested as part of a prospective study incorporating all patients with meningiomas.
Note from the association : Many studies on meningiomas are interesting, whether or not to drugs (Androcur, Lotéran Lotényl, etc.). From a medical point of view, the suffering linked to it and neurosurgery is the same. The difference in management lies on the fact that, if there is no urgency to operate, and depending on the location, the treatment must be stopped to see if the meningioma decreases or stabilizes.
Keywords : meningioma; neurosurgery; postoperative headache; preoperative headache.
Links:
https://pubmed.ncbi.nlm.nih.gov/30089403/#afiliation-1
https://journals.sagepub.com/doi/10.1177/033310241879363636
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