Surgery in tumors of the lateral ventricles – last 8 years experience

Introduction: Tumors of the lateral ventricle are rare lesions including a large variety of benign or malignant tumors. These tumors could originate in the ventricular wall or arising and expanding within the lateral ventricle from the surrounding neural structures. The purpose of this study is to discuss postoperative results and factors that affected the preference for transcallosal or transcortical approach.Material and methods: We performed a retrospective study, lasted between 2005-2013, that comprised 26 consecutive patients who underwent operation for lateral ventricle tumors. The main clinical symptoms and signs were associated with the localization and size of the tumors. Cerebral computed tomography and magnetic resonance imaging were used to determine the location and expansion of each tumor. The transcortical approach was used in 17 patients and the transcallosal approach was used in 9 patients.Results: Total tumor resection was achieved in 73% of cases (19 patients). Most frequent histological tumor’s type was glioblastoma, choroid plexus papilloma, ependymoma and meningioma. Signs of increased intracranial pressure were most dominant. One patient died because of postoperative intraventricular hemorrhage. Additional neurological deficits were seen in 3 patients and postoperative seizure occurred in three patients. One patient with preoperative hydrocephalus required ventriculo-peritoneal shunting after tumor’s resection. Two patients developed postoperative epidural hematoma and one required reoperation. 15 of 26 patients received postoperative radiotherapy and 6 of them received adjuvant chemotherapy. The mean duration of postoperative evaluation was 24,32 (range 5-92). Excepting the cases with subtotal resection, two patients were reoperated for recurrences.Conclusions: The nature, size, location and vascularization of intraventricular tumors are the most important elements influencing the choice of surgical approach. Surgeons must evaluate all these factors and prefer the short and safe way to remove the tumor

Large olfactory groove meningiomas: Clinical outcome considering different surgical approaches

Olfactory groove meningiomas (OGMs) account for 4.5 to 13% of all intracranial meningiomas (1,2). They arise in the anterior cranial fossa at the cribriform plate of the ethmoid bone and the area of the suture adjoining the planum sphenoidale.We performed a large retrospective study of 98 patients (59 females and 39 males) evaluated and operated in the Neurosurgical Department of the National Institute of Neurology and Neurovascular Diseases between 1979 – 2009. This represented 7.93% of all intracranial meningiomas operated in our department (1235 cases). These operations were done by or under the supervision of the senior neurosurgeon (LD). For the surgical removal of the OGMs we used both frontolateral (67 cases) or bifrontal approaches (31 cases). We achieved total removal of the meningioma in most of the cases (93.9%), meaning in 66 patients operated through unilateral frontolateral craniotomy (98.5%), and in 26 patients operated through bifrontal craniotomy (83.9%). As postoperative complications, were encountered: subdural hygroma, postoperative hemorrhage, cerebrospinal fluid (CSF) leak, postoperative seizures, diffuse cerebral edema and local infection. Postoperative mortality was 7.14% (7 patients). Frontolateral approach allowed, even in large OGMs, very good postoperative results, with high rates of total tumor resection and low rates of morbidity and mortality

Koptische literarische Texte (1998–2000)

Abstract In adults, cerebral metastases are the most common intracranial tumors, and their incidence has been rising in the last decades. The median interval between the diagnosis of the primary cancer and the detection of brain metastasis is relatively short, generally around one or two years. This study made a selection of six cases with a more than five years delay until the diagnosis of a cerebral metastases, from over 246 patients with brain metastases, admitted in our department, between 2006-2010. All six patients underwent surgery for their primary neoplasm, prior to neurosurgical diagnosis and treatment. We found 6 patients, having renal, breast or lung cancer, in which the delay between diagnosis of the primary tumor and that of the brain metastases started from 5 years and reached even 18 years. In all cases, this delay was longer than the median interval found in the most neurosurgical series. Very probably the immune system plays a major role in controlling recurrences and new metastases in the nervous syste