Tailored Surgical Approaches for Benign Craniovertebral Junction Tumors
Journal of Korean Neurosurgical Society
; : 139-144, 2010.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-147241
Biblioteca responsable:
WPRO
ABSTRACT
OBJECTIVE:
We report our surgical experience in the treatment of 16 consecutive patients with benign craniovertebral junction (CVJ) tumor, observed from 2003 to 2008 at our department.METHODS:
We had treated 6 foramen magnum meningiomas, 6 cervicomedullary hemangioblastomas, 1 accessory nerve schwannoma, 1 hypoglossal nerve schwannoma, 1 C2 root schwannoma, and 1 cavernous hemangioma. Clinical results were evaluated by Karnofsky Performance Scale (KPS) and all patients underwent preoperative neuroradiological evaluation with computed tomography (CT) and magnetic resonance image (MRI). Angiography was performed in 15 patients and preoperative embolization was done in 2 patients.RESULTS:
Five far-lateral, 1 supracondylar and 10 midline suboccipital approaches were performed. Gross total removal was achieved in 15 cases (94%) and subtotal removal in 1 patient (6%). None of the patients required occipitocervical fusion. Radiological follow-up showed no recurrence in cases totally removed. Postoperative decrease of KPS scores was recorded in only 1 patient. The treatment of cervicomedullary solid hemangioblastoma presented particular issues by preoperative embolization, we removed tumor totally without an excessive bleeding or brainstem injury. In one of foramen magnum meningioma, we carried out subtotal removal due to hard tumor consistency and encasement of neurovascular structures.CONCLUSION:
The choice of surgical approaches and the extent of bone resection should be defined according to the location and size of individual tumors. Moreover, we emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon in tailoring the technique and providing the required exposure for different lesions, without unnecessary surgical steps.
Texto completo:
Disponible
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Recurrencia
/
Tronco Encefálico
/
Angiografía
/
Espectroscopía de Resonancia Magnética
/
Estudios de Seguimiento
/
Hemangioblastoma
/
Foramen Magno
/
Nervio Accesorio
/
Hemangioma Cavernoso
/
Hemorragia
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Journal of Korean Neurosurgical Society
Año:
2010
Tipo del documento:
Artículo