Factors influencing surgical complications of intra-axial brain tumours

Object. Extensive surgical resection remains nowadays the best treatment av ailable for most intra-axial brain tumours. However, postoperative sequelae can outweigh the potential benefits of surgery. The goal of this study has been to review the results of this treatment in our Department in order to quantify morbidity and mortality and determine predictive risk factors for each patient. Method We report a retrospective study of 200 patients submitted to a crani otomy for intra-axial brain tumours including gliomas and metastases. Posto perative major complications are analysed and related to different variable s. An exhaustive review of the literature concerning the main controversial points about primary and metastatic brain tumours surgery is done. Findings. The overall major complication rate was 27.5%, with neurological complications being the most frequently encountered. We did not find a stat istically significant relation between them and the grade of eloquence of t he tumoural area. Infratentorial tumour location, previous radiotherapy and reoperations were factors strongly related to the incidence of regional co mplications. Age over 60 and severe concomitant disease were risk factors f or systemic complications. Interpretation. The results from published series concerning surgical compl ications after craniotomies for brain tumours are not comparable because of the lack of homogeneity between them. The knowledge of the complications r ate in each particular neurosurgical department turns out essentially to pr ovide the patient with tailored information about risks before surgery.