Article
Lateral supracerebellar infratentorial approach for the treatment of intrinsic mesencephalic tumors: clinical experience with pediatric patients
Der lateraler suprazerebellärer infratentorieller Zugang zur Behandlung intrinsischer Hirnstammtumore im Kindesalter
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Published: | May 4, 2005 |
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Outline
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Objective
Surgical treatment of intrinsic brainstem lesions located still represents a challenging task. Aim of this study was to assess the feasibility of the lateral supracerebellar infratentorial (LSI) approach for the treatment of gliomas located in the upper brainstem in the pediatric population.
Methods
Between 1992 and 2002, 11 patients (mean age 8.7y) with benign tumors of glial origin located mainly in the mesencephon and partially extended to the pons and/or thalamus were operated with the LSI approach in a sitting position. In 10 cases a stereotactic biopsy had verified the benign nature of the lesions prior to the LSI procedure.
Results
Satisfactory extent of resection was achieved. Additional morbidity was encountered only temporary in 3 patients. Follow-up ranged from 12 to 60 months. In 2 cases the sterotactic biopsy was misleading and the tumors proved to be WHO IV necessitating postoperative radiotherapy.
Conclusions
In a carefully selected pediatric patient population the LSI approach proved to be a feasible and effective surgical route for the treatment of upper brainstem gliomas.