Abstract
Objective:
To determine the fraction of patients presenting with seizures and explore possible associations between seizure as presenting symptom and sex, age, tumor location, laterality, histology, Karnofsky performance score and prognosis.
Materials and methods:
All patients who underwent primary craniotomy for a meningioma at the Oslo University Hospital, in the time period 1990 – 2010 were included in this study. The patients operated during the years 1990 – 2002 were identified by reviewing operative protocols from this time period, while patients operated after 2002 were identified from our prospectively collected tumor database. All charts were studied retrospectively. The total number of patients identified with a histological verified intracranial meningioma was 1469.
Results:
The frequency of seizures, raised ICP and focal neurological deficits as presenting symptoms were 29.6%, 31.7 % and 60.2%, respectively. Site of dural attachment, laterality of tumor, gender and Karnofsky score showed a significant association with seizures as presenting symptom, while age, WHO grade and right/left tumor location did not. Convexity- and parasagittal tumors most frequently presented with seizures. Falx-, lateral sphenoid wing- and supratentorial skull base had an intermediate frequency of seizures as presenting symptom, while tumors located in posterior fossa or brain ventricles rarely presented with seizures. Male gender and Karnofsky performance status > 70 were positively associated with seizure as presenting symptom. Overall survival (OS) at 1-, 12- and 60- months were 98%, 96% and 88%, respectively. Seizures as presenting symptom was not significantly associated with survival.
Conclusions:
29.6% of the meningioma patients presented with seizures. Seizures as presenting symptom showed a significant positive association with convexity-/parasagittal tumor locations, male gender and high Karnofsky performance score. Seizures as a presenting symptom was not associated with survival.