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Psychosurgery

Psychosurgery

Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...

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Craniopharyngiomas: Surgery and Radiotherapy.

Sergey Gorelyshev¹, Alexander N Savateev², Nadezhda Mazerkina³

¹Federal State Autonomous Institution (N. N. Burdenko National Medical Research Center of Neurosurgery) of the Ministry of Health of the Russian Federation, Moscow, Russia. SGorel@nsi.ru.

Advances and Technical Standards in Neurosurgery

|August 17, 2022

Summary

This summary is machine-generated.

Craniopharyngioma surgery risks hypothalamic damage and recurrence. Combining non-radical surgery with stereotactic radiation improves quality of life and progression-free survival for these challenging brain tumors.

Keywords:

Craniopharyngiomas Endocrine disorders Hormone deficit Long-term survival Radiotherapy Surgery

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Area of Science:

Neurosurgery
Radiation Oncology
Endocrinology

Background:

Craniopharyngiomas are benign tumors often requiring surgical resection.
Tumor invasion of critical structures like the hypothalamus and optic pathways complicates complete surgical removal.
Radical surgery for craniopharyngiomas can lead to irreversible hypothalamic damage, impacting quality of life and survival.

Purpose of the Study:

To evaluate the outcomes of craniopharyngioma treatment strategies.
To compare the efficacy of radical versus non-radical surgical approaches combined with radiation therapy.
To assess the impact on patient quality of life and progression-free survival.

Main Methods:

Analysis of treatment outcomes for craniopharyngioma patients.
Comparison of radical tumor resection versus non-radical resection followed by radiation therapy.
Utilization of stereotactic irradiation techniques for residual tumor treatment.

Main Results:

Radical surgery for craniopharyngiomas carries a significant risk of hypothalamic dysfunction (up to 40%), leading to metabolic and cognitive disorders.
Craniopharyngiomas have a high recurrence rate (10-30% after total resection, up to 85% with residual tumor without radiation).
Non-radical surgery combined with stereotactic radiation therapy results in a higher quality of life and improved progression-free survival compared to radical resection alone.

Conclusions:

Observation of residual tumor after craniopharyngioma surgery is not a recommended strategy.
Stereotactic radiation therapy is crucial for managing tumor remnants and improving outcomes.
A combined approach of non-radical surgery and stereotactic radiation offers a superior quality of life for patients with hypothalamic-infiltrating craniopharyngiomas.