Title : The role of microsurgery on the treatment of Meningioma: A Case Report and literature review
Abstract:
Background: Meningiomas are the most common intracranial tumors, they can occur on any intracranial or spinal dural surfaces and even with benign predominance, are related to neurological deficits and decreased quality of life.
Objectives: This paper aims to demonstrate the importance of recent technologies in the treatment of brain tumors, focusing on meningiomas and how it impacts the patient's life.
Methods: The case reported in this article was directed by contemplating the patient's medical records, being discussed and organized from the most recent literature.
Clinical Presentation: A 52-years-old male relates dizziness, worsening by movement, and headache in the frontal region of the skull, grade 6 in pain scale, which improved by dipyrone administration. The patient was previously diagnosed with hypertension and dyslipidemia. First, the patient was diagnosed with labyrinthitis. Three months later, the symptoms had worsened. At physical examination, he presented proportionated spastic hypertonia, hyperreflexive hemiparesis on the right side. The computerized tomography showed temporoparietal expansive lesions on the right side, possibly from the meningothelial coat. The microsurgery approach was chosen for treatment. The patiente evolved with no post-surgical complications nor neurological deficits and resolution of the symptoms.
Results: Meningiomas come from arachnoid meningolian cells, most of these tumors appear intracranially, but may also have incidence along the spinal cord, they tend to be benign and grow slowly and gradually, sometimes emerging in inaccessible places.
Meningiomas have symptoms common to other tumors, such as headache, seizures, psychosis, memory disorders, diplopia and anxiety, which may delay diagnosis. In addition, meningiomas located in the right temporoparietal region are associated with depressive symptoms, being able to develop symptoms of acute schizophrenia if there is no intervention. Although intracranial neoplasms are more frequent, the scarcity of studies makes molecular profile analysis difficult for individualized therapeutic choices. Then today, in clinical practice, the most widely used method for the diagnosis of meningioma is Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) to assess the stage and thus the severity of the disease.
Therefore, to assist in the choice of management, the World Health Organization (WHO) commonly classifies them as: benign (grade I), atypical (grade II) and malignant (grade III). Although most meningiomas are benign in nature, only incidental and asymptomatic meningiomas are usually accompanied by radiological surveillance, for growing and symptomatic tumors microsurgery is the gold standard treatment due to its efficacy and if residual tumor tissue it is treated with radiotherapy.
Thereby, the microsurgery is a microscopic technique that has advanced over the years, making it effective and safe, in addition to demonstrating a significant increase in the rate of total tumor removal and decreasing postoperative recurrences.
Conclusion: Meningiomas are the most frequent tumors in the nervous system and are commonly benign. Due to the lack of data from the practice of molecular analysis, the diagnosis is mostly performed by imaging, CT and MRI. Thus, allowing to evaluate whether the type of conduct will be expectant, surgical with or without adjuvant treatment, guaranteeing the safety and quality of life of the patient.
What will audience learn from your presentation?
meningiomas are the most common intracranial tumors that require new surgical and therapeutic techniques at all times. Bringing better prognosis and quality of life to patients, in addition to contributing to other cranial tumor treatments.
