Surgical Management of Brain Meningiomas: A Review of Current Techniques and Outcomes.

Review Article

Abstract

Background: Surgical treatment of brain meningiomas is a challenge because of their various sites, sizes and effects on surrounding neural structures.

Objective: This review aims to integrate the current surgical techniques and results in the management of brain meningiomas.

Study Design: The study is a systematic review and meta-analysis.

Setting and Duration of Study: The study was carried out at the Department of Neurosurgery,Bacha khan medical college Mardan , for six months, from 8^th October 2023 to 8^th April 2024.

Methods: A systematic literature search was undertaken to identify recent studies as well as clinical trials about surgical therapy for brain meningioma. It also highlights on microsurgical techniques, endoscopic approaches, advancement in neuro-navigation and intraoperative monitoring.

Results: The inclusive criteria were met by 52 studies which consisted of 18 randomized control trials (RCT) ,24 observational studies and ten meta-analysis. The total number of patients included in these studies was 8420 who underwent surgery for brain meningiomas. Gross total resection (GTR) rates ranged between 70% -95%. Recurrence after GTR varied from5%-15% over a five year follow up period.

Conclusions: Over time, management of Brain Meningiomas has changed due to advancements in technology and technique. Although microsurgical excision remains vital in therapy, endoscopic approaches as well as modern intraoperative adjuncts have widened the neurosurgeons’ armamentarium leading to improved patient outcomes.

Keywords: brain meningiomas, microsurgical resection, neuro-navigation