Objective: To study the clinical characteristics and treatment of meningiomas in children. Methods: One hundred and sixty-six meningiomas in children, including 12 cases treated in Qilu hospital and 8 series reported in the literature, were analyzed retrospectively on sex, age distribution, presenting symptoms, signs, radiological and pathological findings, treatment and prognosis. Results: The ratio of boys and girls was 2.3:1. The age ranged from 0.5 to 15 years (mean 9.9 years). Cranial nerve disorder (28%) and signs of chronic increased intracranial pressure such as headaches (62%), vomiting (53%) and papilledema (55%) were the most common symptoms. The most common location was the cerebral convexity (41%), followed by ventricles (15%), saddle areas (8%), cerebellopontine angles (8%), brain intraparenchyma (5%), parasagittal regions (4%), etc. Homogeneous density was observed in 62.3% of all cases, calcification in 14.8%, cystic components in 21.3% and intratumoral hemorrhage in 1.6%. On average, the epithelial and fibroblastic types of meningiomas took up 55% of the case, while the amount of malignant or atypical meningiomas averaged 9%. Complete tumor excision was achieved in 74%, and postoperative mortality was 3.3%. Conclusions: Compared with meningiomas in adults, meningiomas in children occur predominantly in males with a lower incidence rate of epilepsy, and are frequently associated with multiple neurofibromatosis. Meningiomas in children have a poorer prognosis than those in adults. Degree of the first tumor resection, tumor location, pathological grade and association with neurofibromatosis are the most important factors influencing the patients’ prognoses.

Nuclear factor-κB (NF-κB) plays an important role in the inflammatory response after intracerebral hemorrhage (ICH). We therefore proposed that NF-κB activation in perihematomal brain tissue might correlate with clinical outcome in patients with ICH. To confirm this, we studied clinical data of 45 patients with ICH and NF-κB activation in perihematomal brain tissue and analyzed predictors of clinical outcome as well as the predictive value of NF-κB activation. Forty-five patients with spontaneous basal ganglia hemorrhage were prospectively investigated. The clinical data were collected, which include demographics, alcohol and tobacco abuse, stroke risk factors, neuroimaging variables at presentation, Glasgow Coma Scale (GCS) at admission, number of days in hospital, mechanical ventilation, pneumonia, and outcome. Clinical outcome was assessed by the modified Rankin Scale at 6 months after ICH. Perihematomal brain tissue was collected, and NF-κB activation was detected using immunohistochemistry. Univariate analysis and multivariate logistic regression analysis were performed to determine predictors of the poor outcome. Immunohistochemical detection showed that NF-κB p65 was expressed in the nuclei of neurons and glial cells in all patients. The number of nuclear NF-κB p65-positive cells was 54 ± 21. Six months after ICH, 18 (40%) patients achieved a favorable functional outcome (mRS ≤ 3) while 27 (60%) had a poor functional outcome (mRS 4 to 6). In univariate analysis, predictors of poor functional outcome were lower GCS score on admission (P = 0.004), larger hematoma volume (P = 0.004), intraventricular extension (P = 0.047), midline shift (P = 0.005), NF-κB activation (P < 0.0001), mechanical ventilation (P = 0.018), and co-morbidity with pneumonia (P = 0.002). In multivariate logistic regression analysis, NF-κB activation was the only independent predictor of poor outcome at 6 months after ICH. NF-κB activation is closely related to clinical outcome 6 months after ICH in humans. Therefore, it could be useful to predict prognosis of ICH accurately and should be further evaluated as a target for therapeutic strategies of ICH in the future.