Microsurgical management of pineal region lesions: personal experience with 119 patients
Yükleniyor...
Dosyalar
Tarih
2008
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Science Inc
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background: Lesions of the pineal region are histopathologically heterogeneous but often accompanied with severe progression of clinical signs. Surgical treatment remains challenging because of the close vicinity of the deep venous system and the mesencephalo-diencephalic structures in this region. We present the surgical approaches and techniques in a consecutive series of 119 patients treated by the senior author (J.H.) between 1980 and 2007 at 2 different neurosurgical university centers in Kuopio and Helsinki, Finland. Methods: Of the included patients, 107 (90%) presented with pineal region tumors and 12 (10%) with vascular malformations. The ITSC route was used for removal of the lesion in 111 (93%) patients and the OIH approach in 8 (7%) patients. All except one patient were operated on in a sitting position. Results: We reviewed all clinical data and radiographic images and analyzed all surgical videos. The pineal lesions were removed completely in most cases (88%). There was no Surgical mortality. Twenty-two (18%) of the patients had complications in the postoperative period; these included 1 epidural hematoma, 9 transient Parinaud syndrome, 2 meningitis, 3 wound infections, 2 transient memory disturbances, 2 mild hemiparesis, 1 CSF fistula, and 2 cranial nerves palsies (Wand VI). During a 3.5-year follow-up, 12 patients with malignant lesions died; all patients with benign tumors survived. Conclusions: The ITSC route is a safe and effective surgical approach, associated with low morbidity, complete lesion removal, and definitive histopathologic diagnosis. Considering risk vs benefit, we therefore believe that the surgical treatment can be offered in most cases as the first treatment option for pineal tumors. (C) 2008 Elsevier Inc. All rights reserved.
Açıklama
Dashti, Reza/0000-0002-2257-262X; Niemela, Mika R/0000-0003-1526-0684; CARDIA, Andrea/0000-0002-7349-3753
WOS: 000261701000004
PubMed: 19055952
WOS: 000261701000004
PubMed: 19055952
Anahtar Kelimeler
Infratentorial supracerebellar approach, Occipital interhemispheric approach, Pineal region lesions, Hydrocephalus, Follow-up
Kaynak
Surgical Neurology
WoS Q Değeri
Q2
Scopus Q Değeri
Cilt
70
Sayı
6
