[Urgent neurosurgical operations in neurooncology]

26 patients with intracranial tumors on the stage of severe clinical decompensation were treated in S.P. Botkin Municipal Hospital from 2005 till 2010. The main group (18 cases) included patients who underwent urgent neurosurgical procedures due to decompensation. This group was evaluated prospectively. Control group (8 cases) consisted of patients who received only conservative treatment. Application of this therapeutic tactics allowed decrease of mortality from 100% after palliative conservative treatment to 11% (2 cases) after aggressive surgical management shortly after deterioration. Condition of patients was assessed using GCS. Outcomes were evaluated by GOS. Mean preoperative GCS score was 5.3 in the surgical group. In control group this value was 4. Mean postoperative GOS score was 3.9. In control group mortality reached 100%. Perioperative ICP monitoring demonstrated severe intracranial hypertension in all cases. Analysis showed that urgent decompressive procedure in decompensated patients with intracranial tumors is treatment of choice if antiedematous treatment is ineffective. If no positive dynamics in neurological symptoms is observed, neurosurgeon should immediately perform wide external and internal decompression with duraplasty. Decision about urgent operation is strictly individual and should be based on size and localization of the tumor, concominant diseases, duration of coma and stability of haemodynamics.