Four Independent Predictors of Postoperative Seizures After Meningioma Surgery: A Meta-Analysis

Victor M. Lu, Waseem Wahood, Oluwaseun O. Akinduro, Ian F. Parney, Alfredo Quinones-Hinojosa, Kaisorn L. Chaichana

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Background: Postoperative seizures after surgical resection of intracranial meningiomas will negatively affect the quality of life of patients. The aim of the present meta-analysis was to pool the current data and identify the independent predictors of postoperative seizures to better guide postoperative surveillance. Methods: Searches of 4 electronic databases from inception to February 2019 were conducted using the preferred reporting items for systematic reviews and meta-analyses guidelines. We identified 430 reports for screening. The hazard ratios (HRs) of the preoperative and postoperative parameters from ≥3 separate multivariate regression analyses were pooled using a meta-analysis of the proportions. Results: Of the 430 reports, 12 satisfied the criteria for inclusion in the present study. The pooled population of 5681 patients with meningioma had a median age of 56 years (range, 50–61) and a median proportion of World Health Organization grade I of 91% (range, 66–100). From these data, 4 statistically significant, independent predictors of postoperative seizures were identified: 1) preoperative seizure history (HR, 3.53; P < 0.01), 2) non–skull base location (HR, 2.35; P < 0.01), 3) postoperative complications (HR, 3.95; P < 0.01), and 4) meningioma recurrence (HR, 3.69; P < 0.01). However, the certainty of these results ranged from low to moderate. Conclusions: We identified 4 significant independent predictors of postoperative seizures after meningioma resection. These parameters should be considered in the follow-up of these patients to ensure optimal seizure surveillance, although ultimate validation by prospective studies is still required.

Original languageEnglish (US)
Pages (from-to)537-545.e3
JournalWorld neurosurgery
StatePublished - Oct 2019


  • Meningioma
  • Non–skull base
  • Postoperative
  • Predictors
  • Seizure
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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