• Hajime Wada, Hiroya Shimauchi-Ohtaki, Masahiko Tosaka, Takahiro Kawashima, Tadashi Osawa, Sho Osawa, Keishi Horiguchi, Satoshi Nakata, and Yuhei Yoshimoto.
• Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
• World Neurosurg. 2024 Jun 1; 186: e296e304e296-e304.

ObjectiveGlioma and meningioma require vastly different surgical approaches, even if only involving a simple craniotomy procedure. Diffusion weighted imaging (DWI) is useful for the postoperative evaluation of ischemic damage. The present study evaluated the expected but unproven differences in DWI findings.MethodsA total of 41 patients with meningiomas and 63 with gliomas met the inclusion criteria for adult cases with superficial lesions treated through simple supratentorial craniotomy. Postoperative DWI findings of DWI-positive rate, DWI-positive area type, and relationship with neurological deficits were evaluated.ResultsThe DWI-positive rate (P = 0.01) and the proportion of rim-type lesions (P < 0.01) were significantly more common in gliomas. Patients with meningiomas and DWI-positive areas presented with higher rates of new neurological deficits (P < 0.01), and patients with meningiomas on the left side were more likely to develop new neurological deficits (P = 0.02). Patients with gliomas tended to develop new deficits with larger DWI-positive area volumes (P = 0.04).ConclusionsPostoperative early DWI-positive rate and rim-type lesions are more common after glioma resection than meningioma resection. Larger volumes of DWI-positive areas may be associated with postoperative neurological symptoms in gliomas. DWI-positive finding is less common after meningioma than glioma resection but more likely to be associated with new neurological symptoms. These differences are important for adequate postoperative DWI evaluation of common supratentorial brain tumors.Copyright © 2024 Elsevier Inc. All rights reserved.

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