Could Meningiomas at Certain Locations at the Skull Base have a Higher Incidence of Post-operative Pseudomeningocele and Consequent Communicating Hydrocephalus than Others? (A Retrospective Analysis)

Meningiomas are frequently associated with postoperative pseudomeningoceles. Communicatinghydrocephalus is also a frequent complication of skull base meningiomas. Objectives: Our objective is to perform detailed retrospective analysis to determine whether certain locations have a particular predilection to develop a pseudomeningocele and consequent communication hydrocephalus. Patients and Methods: 78 patients were included in the study. A retrospective analysis was performed. The volume of the meningocele was quantified in cubic milliliters to obtain a quantitative variable suitable for statistical inference, correlation and regression. A one way ANOVA test was used for testing of hypothesis using an alpha of 0.01 and a tabulated F value of 3.19. Results: Analyzing the available data revealed a calculated F value of 7.33 and an R^2 of 0.009 towards tumor location with a tendency towards clinoidal meningiomas. This location showed the highest incidence of pseudomeningoceles and need for shunts. Conclusion: This study was carried on a significant patient cohort and has established a significant difference between meningiomas at various locations and the development of pseudomeningocele and possible consequent communicating hydrocephalus. Meningiomas at the region of the anterior clinoid process have had the highest incidence and the larger number of patients requiring shunts. Meningiomas at the caraniocervical junction came second in place. Other factors that have previously been shown by others to correlate as well as our study include, blood loss and length of the surgical procedure.