Surgical Management of Giant Intracranial Meningiomas: Key Considerations and Postoperative Results

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Objective: Giant intracranial meningiomas (GIM) present significant surgical challenges due to their size and involvement with critical neurovascular structures.This study aims to evaluate key surgical considerations and postoperative outcomes for patients undergoing resection of GIM and to highlight factors influencing recurrence-free survival and patient prognosis.Methods: A retrospective review was conducted of 8 patients with GIM (>5 cm in diameter) who underwent surgical resection between 2021 and 2023.Demographic data, tumor characteristics, surgical techniques, and postoperative outcomes were analyzed.Tumor size, extent of resection, and recurrence were assessed through imaging and clinical follow-up.Results: The cohort included 3 males (37.5%) and 5 females (62.5%) with a mean age of 56.4 years.The most common tumor location was the olfactory groove (37.5%).The mean tumor volume was 107.6 cm 3 , and the mean follow-up duration was 9.6 months.Gross total resection (Simpson grade 2) was achieved in 75% of cases, while subtotal resection (Simpson grade 4) was achieved in 25% of cases.Two patients with World Health Organization grade 2 pathology received postoperative radiotherapy.No major postoperative complications were observed, and the mean duration of hospitalization was 11 days.Conclusion: Surgical resection of GIM remains a challenging but essential approach to managing these complex tumors.While gross total resection is the preferred goal, subtotal resection may be necessary to preserve neurological function.Postoperative radiotherapy may be required in higher-grade tumors.Tumor location, vascularity, and advanced intraoperative techniques significantly influence surgical outcomes and recurrence-free survival.

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