title: [Own experience in surgical treatment of the pineal region and midbrain tumors via the infratentorial approach].
abstract: Nine cases of tumours located in the pineal and midbrain region in adults operated on between November 1998 and July 2002 in Dept. of Neurosurgery, Central Military Hospital in Warsaw are reported. The patients (2 men and 7 women) were aged from 27 and 69 years (mean age 43.6 years). Their main initial symptoms were caused by hydrocephalus. The histopathological examination revealed anaplastic pinealoma in 2 cases, and pineocytoma, pineal cyst, mesencephalic glial cyst, protoplasmatic astrocytoma, epidermoid cyst, unclear glial scar, and papillary ependymoma in single cases. Five patients had been treated, usually elsewhere, with shunt implantation prior to the surgery. Occipito-suboccipital osteoplastic craniotomy was performed in each case and tumours were totally removed microsurgically via the infratentorial epicerebellar approach. In one case a part of the glial periaqueductal tumour was resected additionally via the fourth ventricle and aqueduct in one stage. Postoperative haematomas in the third and fourth ventricle were found in 2 cases. Main complaints after the surgery included transient diplopia. All the patients improved significantly and resumed their previous life activities. Follow-up ranged from 3 to 44 months. Three patients with pineal tumours and one with a small postoperative ependymoma recurrence were irradiated after the surgery. One patient had been irradiated prior to surgery. Very good results of the surgical treatment of tumours in this area suggest that such patients should be referred earlier to one stage surgical management, as the procedure is easier to perform and shunt implantation may be avoided.
authors.affiliation: Kliniki Neurochirurgii Centralnego Szpitala Klinicznego WAM w Warszawie.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Koziarski
authors.forename: Ewa
authors.initials: E
authors.lastname: Skrobowska
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zieliński
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Warczyńska
authors.forename: Jan K
authors.initials: JK
authors.lastname: Podgórski
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010871:Pinealoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D017287:Ventriculoperitoneal Shunt