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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

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Cardiac pacemaker for brain stem tumors

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  • corresponding author V. D'Angelo - Neuroscience Department, “Casa Sollievo Sofferenza” Hospital and Scientific Research Institute, S. Giovanni Rotondo, Italy
  • L. Gorgoglione - Neuroscience Department, “Casa Sollievo Sofferenza” Hospital and Scientific Research Institute, S. Giovanni Rotondo, Italy
  • A. Ceddia - Neuroscience Department, “Casa Sollievo Sofferenza” Hospital and Scientific Research Institute, S. Giovanni Rotondo, Italy
  • V. Carotenuto - Neuroscience Department, “Casa Sollievo Sofferenza” Hospital and Scientific Research Institute, S. Giovanni Rotondo, Italy
  • C. De Bonis - Neuroscience Department, “Casa Sollievo Sofferenza” Hospital and Scientific Research Institute, S. Giovanni Rotondo, Italy
  • M. Zarrelli - Neuroscience Department, “Casa Sollievo Sofferenza” Hospital and Scientific Research Institute, S. Giovanni Rotondo, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.04.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc233.shtml

Veröffentlicht: 30. Mai 2008

© 2008 D'Angelo et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

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Objective: Surgical treatment of neoplasms arising from the ponto-medullary region or involving lower cranial nerves or the cervico-medullary junction is a dangerous condition in clinical practice, mostly because of the high rate of heart disturbances and reduction of cerebral perfusion. The use of atemporary cardiac pacemaker during the operative time should reduce the risk of such an event thereby improving the surgical procedure.

Methods: Thirty-two patients with posterior fossa tumors (22 with intra-axial and 10 with extra-axial lesions) underwent positioning of a temporary cardiac pacemaker before surgery. Age patient range was 10 months – up to 74 years (mean 39,9 yrs). Tumors were located at the ponto-medullary junction in 16 patients, at the cervico-medullary level in the other 11 cases and near the ventro-medullary area/lower cranial nerves for the last 5. During surgery, the heart rate (ECG), mean arterial blood pressure (MABP), blood gas analysis (BGA) and venous jugular vein oxygen saturation SjvO2 were monitored.

Results: ThepPacemaker stimulated the heart rate five times in six patients with tumors at the cervico-medullary junction and for 2 patients, harbouring a ponto-medullary lesion, cardiac pacing was recorded during lesion mobilization at removal. Cardio-circulatory and methabolic parameters remained stable during surgery. A prolonged assisted post-operative ventilation, ranging from 4 days to 18 days, was necessary for 45% of the patients while the cardiac pace-maker was removed 3-4 days after surgery.

Conclusions: Temporary cardiac pacing could represent an useful tool for neurosurgery. Tumors arising from the ponto-bulbar and cervico-medullary areas or involving lower cranial nerves could be removed, while minimizing the intraoperative cardiac and circulatory imbalance due to direct and indirect manipulation of these regions. This allowed a more extensive tumor removal.