Introduction: The existence of atypical and malignant meningiomas was first recognized in 1938, and well defined by the World Health Organization (WHO)in 2000 revised in 2007. They represent about 5.7 to 10% of all Intracranial meningiomas.
Methods: 20 years retrospective study from 1990 to 2010 concerning all intracranial meningiomas treated in our neurosurgical department in University Hospital Center IBN RUSHD in Casablanca, Morrocco.
Results: in this period, 772 intracranial meningiomas were treated, 21 were atypical (2.59%) and 23 were malignant (2.98%). Mean age was 40.29 years old and 25% were under 16, with a range from 1 month to 86 years old. Sex ratio was 1. clinical signs were not specific. MRI and brain CT showed heterogeneous lesions with cysts, calssification and important edema in most cases. resection quality was Simpson I in 59% of cases and Simpson IV in 38,63% of cases, a biopsy was done in 1 patient. 12 patients received radiotherapy after surgery. With a mean long term follow up, about 34% of cases presented one time to four time meningioma reccurence, with a global survival of 58% at 5 years and 48% in 10 years.
Conclusions: Despite finding of malignancy, Simpson I resection and low rate of reccurence were the two important prognosis factors in our serie.
Patient Care: as a neurosurgical center of a developping country, we want to share our technical difficulties nad discuss some tips to well treat our patients with agressive tumors such atypical and malignant meningiomas
Learning Objectives: 1)Discuss prognosis factors in treatment of atypical malignant meningioma comparing to other series
2)Discuss the necessity of post operative radiotherapy
3)sharing our technical difficulties with other neurosurgical centers.