From the Research
Introduction to Hematological Findings in Meningioma
Hematological findings in meningioma are crucial for understanding the progression and treatment of the disease. Meningiomas are typically benign tumors, but their hematological characteristics can provide valuable insights into their behavior and potential complications.
Preoperative Hematological Parameters
Preoperative hematological parameters, such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, albumin-to-globulin ratio, D-dimer, fibrinogen, and lactate dehydrogenase, have been associated with the progression-free survival of patients with meningioma 1. These parameters can be used to construct a hematological risk model (HRM) to predict the progression of the disease.
Hematological Risk Model (HRM)
The HRM has been shown to have excellent prognostic stability and general applicability in different subgroups of patients with meningioma 1. The model can be used in conjunction with clinical prognostic factors, such as age, tumor location, tumor size, peritumoral edema, extent of resection, Ki-67 index, and postoperative radiotherapy, to predict the progression of the disease.
Bleeding Patterns in Meningioma
Meningiomas can present with different bleeding patterns, including purely intratumoral hemorrhage (type I), purely extratumoral hemorrhage (type II), and combined intra/extratumoral hemorrhage (type III) 2. The symptoms and treatment strategies for each type of bleeding pattern can vary, with type III patients often requiring emergency surgery.
Risk Factors for Post-Operative Hematoma
Post-operative hematoma is a significant complication of meningioma surgery, and several risk factors have been identified, including age, invasion of venous sinus by the meningioma, tumor vascularization, arachnoidal infiltration, pre-operative prophylaxis of thromboembolic events, peri-operative coagulation abnormalities, residual tumor, location, and histology of the tumor 3. Patients older than 70 years have a six-fold increased risk of developing a post-operative hematoma.
Preoperative Hematological Inflammatory Markers
Preoperative hematological inflammatory markers, such as leukocyte, neutrophil, and monocyte counts, and lymphocyte-to-monocyte ratio (LMR), can be useful in predicting the pathological grade of meningiomas 4. High leukocyte count and low LMR have been identified as independent predictive factors for high-grade meningiomas.
Treatment and Management
The treatment and management of meningioma depend on various factors, including the size, location, and grade of the tumor, as well as the patient's overall health. Surgery is often the primary treatment option, and the goal is to remove the tumor completely. However, the risk of post-operative hematoma and other complications must be carefully managed.
Dosage and Duration
There is no specific dosage or duration of treatment that applies to all patients with meningioma. The treatment plan is individualized based on the patient's unique needs and circumstances.
Differentials and Caveats
It is essential to consider other potential causes of symptoms and complications when diagnosing and treating meningioma. A thorough evaluation of the patient's medical history, physical examination, and diagnostic tests is necessary to rule out other conditions and develop an effective treatment plan.
Caveats
The treatment of meningioma can be complex, and patients should be closely monitored for potential complications, such as post-operative hematoma, infection, and neurological deficits. Regular follow-up appointments with a healthcare provider are crucial to ensure the best possible outcomes.