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Intraventricular Pilocytic Astrocytoma: A Single Centre Experience
Chinmaya Dash1, Skanda Moorthy1, Kanwaljeet Garg1
1Department of Neurosurgery, AIIMS, New Delhi, India.
Neurology India
|September 9, 2022
Summary
Intraventricular pilocytic astrocytomas (IVPAs) are rare tumors. Diagnosis is challenging, and they can be highly vascular, posing surgical risks like significant blood loss, though calcification may reduce bleeding.
Area of Science:
- Neuro-oncology
- Pediatric Neurosurgery
- Neuroradiology
Background:
- Intraventricular pilocytic astrocytomas (IVPAs) represent a rare subset of pilocytic astrocytomas, comprising 4%-15.6% of all cases.
- This study focuses on the radiological characteristics, surgical management, and outcomes of 15 patients diagnosed with IVPA.
Purpose of the Study:
- To delineate the clinical presentation, radiological findings, and surgical challenges associated with rare intraventricular pilocytic astrocytomas.
- To provide insights into the management and outcomes of these uncommon tumors.
Main Methods:
- A retrospective analysis of 15 patients with histopathologically confirmed IVPA between January 2010 and August 2018.
- Radiological data were sourced from PACS, while surgical and follow-up details were extracted from medical records and operative notes.
Main Results:
- Headache and progressive vision loss were the most frequent symptoms, with a mean duration of 9.88 months.
- Preoperative CT scans revealed calcifications in most IVPAs, with heterogeneous contrast enhancement on post-gadolinium MRI. Mean blood loss during surgery was 1969 ml.
- One patient experienced mortality due to meningitis and septic shock.
Conclusions:
- Intraventricular pilocytic astrocytomas (IVPAs) present diagnostic challenges preoperatively due to their variable radiological profile.
- These tumors can be highly vascular, leading to substantial intraoperative blood loss, although calcification may correlate with reduced bleeding.
- Effective surgical management requires careful consideration of potential complications and tumor characteristics.
