Assuntos
Vértebras Cervicais/lesões , Fraturas da Coluna Vertebral/complicações , Artéria Vertebral/lesões , Insuficiência Vertebrobasilar/etiologia , Acidentes de Trânsito , Adulto , Tronco Encefálico/irrigação sanguínea , Mergulho/lesões , Humanos , Masculino , Radiografia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/diagnóstico por imagemRESUMO
The medical records and histological specimens from 26 patients with choroid plexus papillomas operated on at one institution were reviewed retrospectively. Four patients died perioperatively, and 21 of the remaining 22 patients were followed through March, 1986; the patient lost to follow-up review was last seen 14 years postoperatively. Of the 14 patients who underwent gross total removal of their tumor, one had a recurrence at 11 years postoperatively and two died in the perioperative period. Of the 12 patients who underwent subtotal removal of their tumor, two died in the perioperative period. The two patients who did not have radiation therapy postoperatively are free of apparent disease at 6 and 8 years after their operation. Eight patients underwent radiation therapy after subtotal removal of their tumor; four of these remain alive and well, and four have died of progressive disease. The role of irradiation in the treatment of subtotally resected lesion remains controversial, but this therapy is thought to be indicated for recurrent disease after a surgical excision that is as complete as possible. Histopathologically, the presence of occasional mitotic figures, microscopic infiltration, ependymal differentiation, or mild to moderate atypia was not correlated with likelihood of complete resectability or tendency to recurrence.
Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Plexo Corióideo , Papiloma/cirurgia , Adolescente , Adulto , Neoplasias do Ventrículo Cerebral/patologia , Neoplasias do Ventrículo Cerebral/radioterapia , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Papiloma/patologia , Papiloma/radioterapia , Estudos RetrospectivosRESUMO
Six patients with juvenile pilocytic astrocytomas of the thalamus or basal ganglia underwent seven computer-assisted stereotactic laser craniotomies with complete or nearly complete removal of the tumor in all cases. The tumor was located in the right basal ganglia in one patient, the left basal ganglia in one patient, and the left thalamus in four patients. Postoperative assessment of the completeness of tumor removal was confirmed by contrast-enhanced computed tomographic scanning within the first 2 weeks after operation. None of the patients was neurologically worse after the procedure, and five were improved. The duration of follow-up ranged from 6 months to 3.5 years. In this group of patients, the computer-assisted, stereotactically guided resection of these deeply located, benign tumors was accomplished with no morbidity or mortality.
