Surgery for convexity/parasagittal/falx meningiomas

Incidence of the complication related with the surgical treatment of meningiomas in the title was reviewed together with consideration of data about progress observation and stereotactic radiosurgery. MEDLINE papers in English were on line searched with keywords contained in above using PubMed System. For the convexity meningioma, 50-141 cases (mean age, 48-58.9 y) with 1.9-3.6 cm or 146.3 mL of the tumor size or volume were reported in 6 literatures (2006-2011), presenting 0% of surgery related death, 1-5.9% of internal medical or 5.5-37.4% of surgical complication, 0-2% of postoperative hemorrhage, 0-15.4% of neurological and 0-15.4% of prolonged/permanent deficits. For the parasagittal/falx meningioma, 46-108 cases (age, 55-58 y) with 1.9-4 cm tumor were reported in 8 literatures (2004-2011), presenting 0-5.7% death, 2-7.4% medical or 5.4-31% surgical complication, 0-3% hemorrhage, 0-15.4 neurologic and 0-15.4% prolonged deficits. For complications after the radiosurgery of the all 3 meningiomas, 41-832 cases (50-60 y) with tumors of 24.7-28 mm or 4.7-7.4 mL were reported in 8 literatures (2003-2012), presenting the incidence of 6.8-26.8% of radiation-related complications like headache, seizures and paralysis necessary for steroid treatment, and 1.20 or 4.80% of permanent morbidity. For the natural history of incidental meningiomas involving tentorium one, 16-144 cases in 6 literatures (2000-2012) revealed the growth rate/y of 1.9-3.9 mm or 0.54-1.15 mL. The outcome of surgical treatment of the meningiomas, a representative benign tumor, was concluded to be rather good as surgery was generally needed only when the disease became symptomatic due to the tumor growth. (T.T.)