The Clinical-Radiological Grading System (CGRS) can be used to evaluate a patient prior to resection of an intracranial meningioma.
Patient selection: intracranial meningioma
Parameter:
(1) diameter in cm
(2) neurologic status
(3) Karnofsky performance status (KPS)
(4) critical location (attached to primary vascular or nervous structure such as cranial base or an eloquent area)
(5) peritumoral edema
(6) concomitant disease
Parameter
Finding
Points
diameter
> 6 cm
1
4 to 6 cm
2
< 4 cm
3
neurologic status
unrecoverable deficit
1
progressive deficit
2
no deficit, only seizures
3
KPS
<= 50
1
60 to 80
2
90 or 100
3
critical location
highly
1
moderately
2
not critical
3
peritumoral edema
severe
1
moderate
2
absent
3
concomitant disease
decompensated (uncontrolled despite medical therapy)
1
compensated
2
absent
3
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 6
• maximum score: 18
• The lower the score the worse the patient's status.
• Caroli et al found that a score > 10 and female sex are associated with a good survival after surgery. A patient with a score of 10 or less is not a good candidate for surgery.
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