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Direct surgery for brainstem tumours.

A Bricolo1, S Turazzi, L Cristofori

  • 1Department of Neurosurgery, University Hospital, Verona, Italy.

Acta Neurochirurgica. Supplementum
|January 1, 1991
PubMed
Summary
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Direct surgical excision for brainstem tumors shows low mortality and morbidity. Advanced imaging and microsurgery contribute to favorable patient outcomes in this review of 45 cases.

Area of Science:

  • Neurosurgery
  • Oncology
  • Neurology

Background:

  • Brainstem tumors present significant surgical challenges.
  • Previous reports on surgical outcomes for these tumors vary.
  • Advancements in imaging and surgical techniques necessitate updated outcome analyses.

Purpose of the Study:

  • To evaluate the safety and efficacy of direct surgical excision for brainstem tumors.
  • To assess patient outcomes, including neurological status and long-term survival.
  • To identify factors contributing to successful surgical management of brainstem tumors.

Main Methods:

  • Retrospective review of 45 patients (ages 2-63) treated with direct surgical excision for brainstem tumors.
  • Preoperative evaluation included NMR imaging, CT scanning, and sometimes digital-subtraction vertebral angiography.

Related Experiment Videos

  • Tumor classification based on Epstein and McLeary criteria (focal, cervicomedullary, diffuse).

    • Main Results:

    • Most frequent diagnosis was glioma (36 cases); other diagnoses included cavernoma, haemangioblastoma, and lipoma.
    • Gross total resection achieved in 28 patients; subtotal resection in 16.
    • No operative mortality; 2 early postoperative deaths. Neurological status improved or unchanged in 35 patients at discharge.
    • At 3-month follow-up, 12 patients improved, 27 unchanged, 3 worsened. By January 1990, 27 of 40 patients were alive, with varying degrees of recovery.

    Conclusions:

    • Microsurgical resection of intra-axial brainstem tumors is associated with low mortality and morbidity.
    • Favorable outcomes are attributed to high-quality NMR imaging, efficient microsurgery, adequate anesthesia, and intensive postoperative care.
    • Direct surgical excision, when feasible, offers a viable treatment option for selected brainstem tumors.