ABSTRACT
AIMS: To study the nature of the tumours managed in the Irish population. METHODS: This audit research was completed via a retrospective medical review on 200 patients with CNS tumours managed in a tertiary care centre between 2008 and 2009. RESULTS: The mean age was 53 years. The male:female ratio was 2:1. The majority were glioblastomas and astrocytomas. Grade IV tumours were predominant (65.5 %). Headaches (37 %), motor weakness (32 %) and seizures (25.5 %) were the highest presentations. The commonest sites affected were the left parietal and left temporal lobes. There were 17.5 % operative morbidities with motor weakness (22.9 %), seizure (14.3 %) and thrombo-embolism (14.3 %) dominating and significant association to surgical radicality (p = 0.041). 3.5 % operative mortalities were reported. 52.5 and 62.5 % of patients received adjuvant chemotherapy and radiotherapy, respectively. CONCLUSIONS: Patients with CNS tumours typically had multiple presentations. More extensive surgical resection was associated with higher postoperative morbidities (p = 0.041). The 30-day postoperative morbidity (17.5 %) and mortality (3.5 %) were concordant with the currently available literature.
Subject(s)
Astrocytoma/surgery , Central Nervous System Neoplasms/surgery , Glioblastoma/surgery , Neurosurgical Procedures , Adolescent , Adult , Aged , Aged, 80 and over , Astrocytoma/complications , Astrocytoma/mortality , Central Nervous System Neoplasms/complications , Central Nervous System Neoplasms/mortality , Chemotherapy, Adjuvant , Child , Child, Preschool , Female , Glioblastoma/complications , Glioblastoma/mortality , Headache/etiology , Humans , Infant , Ireland , Male , Medical Audit , Middle Aged , Motor Neuron Disease/etiology , Neoplasm Grading , Neurosurgical Procedures/adverse effects , Neurosurgical Procedures/mortality , Radiotherapy, Adjuvant , Retrospective Studies , Seizures/etiology , Tertiary Care Centers , Thromboembolism/etiology , Treatment Outcome , Young AdultABSTRACT
To ensure continuing patient care in a cost effective and efficient manner and to determine the importance of routine pre-op bloods in patients undergoing spine surgery, a retrospective audit of 170 patients was carried out in the Neurosurgery Department at Cork University Hospital. There were 94 males and 76 females. No test had less than 87.4% normal results. There were 17 (10.7%) abnormal haemoglobin levels, 13 (8.2%) abnormal white cell count levels, 14 (8.9%) abnormal creatinine levels and of sodium and potassium levels, 5 (3.2%) and 3 (2%) were abnormal respectively. Of the abnormal results, the majority fell close to reference range. 95% of the total cost incurred in performing the procedure was attributed to normal blood results. Abnormal blood results in this cohort of patients did not alter management. We conclude that routine blood tests, including coagulation screen, may not be necessary in healthy individuals undergoing elective spine surgery.
Subject(s)
Hematologic Tests , Preoperative Care , Spinal Diseases/surgery , Adult , Aged , Aged, 80 and over , Female , Hematologic Tests/economics , Humans , Ireland , Male , Middle Aged , Preoperative Care/economics , Retrospective Studies , Unnecessary Procedures/economicsABSTRACT
Symptomatic granular cell tumours of the neurohypophysis are rare sellar lesions. Preoperative prediction of the diagnosis on the basis of radiological appearance is useful as these tumours carry specific surgical difficulties. This is possible when the tumour arises from the pituitary stalk, rostral to a normal pituitary gland. This has not been emphasized previously.
Subject(s)
Granular Cell Tumor/diagnosis , Pituitary Gland, Posterior , Pituitary Neoplasms/diagnosis , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Pituitary Gland, Posterior/pathology , Pituitary Neoplasms/pathology , Pituitary Neoplasms/surgery , Treatment Outcome , Visual AcuityABSTRACT
A retrospective review was performed of the age profile and clinical features at presentation of 79 children with posterior fossa tumours. The mean age at presentation in this series (6.6 years) is consistent with a decreasing trend over the past 70 years. Headaches, ataxia and torticollis emerge as significant symptoms worthy of further investigation whilst abdominal pain and constipation might herald the presence of a posterior fossa tumour on rare occasions.
Subject(s)
Skull Base Neoplasms/diagnosis , Skull Base Neoplasms/epidemiology , Adolescent , Age Distribution , Child , Child, Preschool , Cranial Fossa, Posterior , Female , Humans , Incidence , Infant , Infant, Newborn , Ireland/epidemiology , Male , Neurosurgical Procedures/methods , Neurosurgical Procedures/mortality , Retrospective Studies , Risk Factors , Sex Distribution , Skull Base Neoplasms/surgery , Survival RateSubject(s)
Empyema, Subdural/diagnosis , Adult , Empyema, Subdural/diagnostic imaging , Female , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Metastatic carcinoma of the prostate is a common cause of spinal cord compression. In this review of 37 men who underwent laminectomy for this condition this was the first presentation of previously undiagnosed cancer in 11 (29%). One year after decompression 17 (50%) were alive. Twenty patients (59%) could walk after laminectomy. All but 8 were relieved of pain and bladder function was improved in 13 (38%). Those ambulant before laminectomy (7) and those with occult prostate cancer did particularly well. Poor results were associated with a rapid onset of paraparesis and pre-operative progression to paraplegia. A delay in diagnosis was detrimental to outcome. A high index of suspicion in patients with carcinoma of the prostate is essential so that early diagnosis can be made before paraplegia is established. Carcinoma of the prostate must always be excluded in men with cord compression of unknown aetiology.
