Presenting Symptoms and Prognostic Factors for Symptomatic Outcomes Following Resection of Meningioma

Background: Meningioma is the most common primary intracranial tumor and patients present with diverse neurologic symptoms related to meningioma location. This study aimed to systematically quantify the presenting symptoms of meningioma and identify prognostic factors for symptomatic outcome following resection. Methods: Two-hundred and eighty-three patients who underwent resection of a total of 313 meningiomas at a single institution were retrospectively identified, including 161 World Health Organization grade I (52.6%), 108 grade II (35.5%), and 37 grade III meningiomas (12.1%). Patient-reported symptoms were extracted from the medical record and dichotomized into acute (<3 months) and long-term (3–12 months) categories. The χ² test and multivariate regression were used to compare groups. Results: Patients presented primarily with headaches (48.2%) and either cerebral dysfunctions (48.5%) with convexity meningiomas or cranial nerve deficits (38.9%) with skull base meningiomas. Symptomatic improvement in the acute postoperative period was significantly correlated with long term symptomatic improvement (P ≤ 0.01). Headaches and seizures had the greatest rates of symptomatic improvement after surgery (78%), and the vast majority of patients with symptom improvement experienced complete resolution (86%). In contrast, symptoms persisted in >60% of patients with anosmia, sensory changes, or frontal, temporal, or cerebellar symptoms. Multivariate regression identified subtotal resection as a prognostic factor for persistent symptoms (odds ratio, 0.62; 95% confidence interval, 0.03–1.21; P = 0.041). Conclusions: Symptoms improve in the majority of patients after resection of meningioma, with the rate of improvement varying according to symptom type and extent of resection. These data may be a useful when counseling patients about symptoms after resection of meningiomas.