Does Surgical Removal of Skull-Base Meningiomas (WHO I) Affect Life-quality and Cognition?

Background: Removal of skull-base meningiomas is challenging, and besides deficits, life quality and cognition were put into the limelight. Methods: In this prospective study 58 patients underwent neurological examination and neuropsychological testing at three time-points before (1 day) and after surgery (3 and 12 months). For neuropsychological assessments different tests were used: EORTC questionnaire (life-quality), HADS scale (depression), VLML test (memory, learning), and the TMT-A/B test (attention, executive functioning, cognitive speed). For statistical analyses the Qui-quadrate test, the Wilcoxon test, and the Pearson correlation were exerted. Results: Overall 58 patients were included. Tumors were located predominately in the frontal cavity (n = 31) and had an average size of 38 × 32 mm. On admission, 51 patients had cranial nerve deficits. Since tumor infiltration into vessels, the cavernous sinus or the osseous skull base, in nine patients tumor resections remained subtotal. Three months after surgery, in five patients deterioration of symptoms persisted. In the neuropsychological testing there was no correlation between life quality and symptoms, postoperative deficits, tumor size or location, and age. Tumor size and age, however, showed significant negative effects on cognitive abilities after surgery expressed by the TMT, VLMT, recognition, and figurative memory (p < 0.05). Conclusion: Tumor size and age of patients with skull-base meningiomas affect cognitive abilities after surgery.