ArticleCureus2025
Surgical Experience of Supratentorial Meningiomas Without Preoperative Embolization in a Low-Income Country: A Retrospective Observational Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
objectiveTo evaluate the outcomes of supratentorial meningioma resection performed without preoperative embolization at a high-volume neurosurgical public center in Pakistan.
methodsThis retrospective observational study reviewed 100 consecutive patients who underwent surgical excision of supratentorial meningiomas between January 2022 and December 2024 at the Punjab Institute of Neurosciences, Lahore. Patients aged 15 years or older with radiological and histopathological confirmation were included; infratentorial tumors and biopsy-only cases were excluded. Clinical, imaging, and operative data were analyzed. Mean ± standard deviation (SD) values were calculated for operative time, anesthesia time, and estimated blood loss. Pearson correlation analysis was applied to evaluate the relationship between operative duration and blood loss. Extent of resection, perioperative complications, and functional outcomes at discharge were also assessed using the Karnofsky Performance Score (KPS) and Glasgow Outcome Scale (GOS). Patients were followed clinically and radiologically for a median duration of one month (range: two weeks to three months) after surgery to record early postoperative outcomes.
resultsThe cohort had a mean age of 46.3 years, with a female predominance of 69 (69%). Headache was observed in 65 (65%) patients, and seizures in 40 (40%). Gross total resection was achieved in 95 (95%) cases, and near-total resection in 5 (5%). The mean operative time was 193 ± 22 minutes, anesthesia time 220 ± 25 minutes, and estimated blood loss 686 ± 145 mL. A moderate positive correlation was observed between operative time and blood loss (r = 0.56). Early postoperative complications included new motor deficits, hydrocephalus, cerebrospinal fluid leak, and shunt requirement, with low in-hospital mortality. Most patients demonstrated favorable early functional recovery (KPS >80, GOS 5).
conclusionSupratentorial meningioma surgery without preoperative embolization can achieve favorable early outcomes when performed with disciplined microsurgical technique, controlled hemostasis, and coordinated perioperative care. The findings emphasize that safe maximal resection is feasible even in resource-limited settings and support the need for future multicenter comparative studies, including embolized cohorts.
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