Diagnosis and surgical treatment of sporadic meningioangiomatosis

Abstract

Objective: To discuss the clinical characteristics, radiological features, surgical treatment and prognosis of sporadic meningioangiomatosis (MA).

Methods: We retrospectively analyzed the medical records of ten histopathologically confirmed MA patients who were treated in the Department of Neurosurgery of Huashan hospital from 2002 to 2011. All of the patients presented with symptomatic seizure attacks before craniotomy surgeries. Magnetic resonance imaging (MRI) and/or computed tomography (CT) were the main radiological examination for preoperative diagnosis of all cases.

Results: All patients underwent craniotomy surgeries with gross total resections (GTRs) of the MA lesions. Postoperative follow-ups range from 8 to 108 months, in average 42.7 months, median 40.5 months. No radiological recurrence can be found in any case. Eight patients (80.0%) have achieved total symptomatic remission after surgeries (one of them underwent delayed remission), while two (20.0%) are still suffering from seizure attacks infrequently under several antiepileptic drugs (AEDs).

Conclusion: Although MA cases are quite rare and usually misdiagnosed presurgically, a correct preoperative diagnosis, at least a differential diagnosis, can be rationally achieved via a triad of patients' ages, symptomatic seizure attacks and radiological features (both CT and MR). MA is curable and the prognosis is excellent since most patients became free of seizure and recurrence after surgical treatments.

Keywords: Intractable seizure; Neurofibromatosis type 2 (NF2); Radiological features; Sporadic meningioangiomatosis (MA); Surgical treatment.