• Victor M Lu, Waseem Wahood, Oluwaseun O Akinduro, Ian F Parney, Alfredo Quinones-Hinojosa, and Kaisorn L Chaichana.
• Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: lu.victor@mayo.edu.
• World Neurosurg. 2019 Oct 1; 130: 537-545.e3.

BackgroundPostoperative 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.MethodsSearches 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.ResultsOf 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.ConclusionsWe 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.Copyright © 2019 Elsevier Inc. All rights reserved.

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