gms | German Medical Science

Objective: Nowadays, intraoperative sonography is a useful tool in neurosurgery, especially in brain tumor’s surgery [1]. We began its use back in 2006, and our objective is to describe the experience in trans-operatory neurosonography for brain tumors (Meningioma and Glial-tumors) treatment in our Hospital. Also, we point out features to look for in trans-surgery neurosonography

Methods: Revision of files from patients that went to neurosurgery from April 2012 to January 2017 with Meningioma and Glial tumor diagnosis was made. It includes those patient’s files with evidence of use of ultrasonography: before, during and after surgery, confirmation of histological tumor’s type and follow up for Neuropsychology department, that were use to record functional state after procedure.

Results: From 415 patients: 54 were Meningiomas, sonography before dural opening showed the position of cortical and tumoral vessels, the site of contact between tumor and dura, boundaries and size of tumor. It has to be mentioned that in the specific case of Intraventricular-Meningioma, ultrasound helps to indentify the most safe and precise entry-point through brain cortex. On the other hand, Glial tumors were 120 (High and low grade); sonography before dural opening showed the depth and size of tumor, and vessels (normal and new-formed). In both cases, neurosonography allowed the control of the volume of tumor that was extracted and the quantity of residuary. In the end of surgery, we use sonography to identify, residual and active, bleeding sites, which helps to solve them before they become a complication in the patient’s outcome.

Conclusion: Trans-operatory sonography in brain tumor excision showed: size, presence of vessels and depth of lesion, as well as residuary tumor and sites of bleeding. It increases patient’s safety during and after surgery at time it decreases complications and time of in-hospital stay. Also, it provides real-time guide through surgery.