[Results of the operative treatment of intramedullary gliomas].
OBJECTIVE
To assess the results of the operative treatment of intramedullary gliomas.


METHODS
In 1995-2002, 30 patients with intramedullary tumors were treated surgically in the Department of Neurosurgery in Sosnowiec. Among them 23 intramedullary gliomas were recognized. There were 8 females and 15 males aged from 11 to 61. The condition of the patients before the operation was assessed according to a modified McCormick's scale. Only two patients were found to be in a good condition -- I degree, 17 patients (74%) -- II degree or III degree and 4 patients were in a serious condition -- IV degree. Among the operated tumors only 9 had a clear border. There were 5 ependymomas (grade I) and 4 anaplastic ependymomas (grade III). The remaining ones were astrocytomas of varying malignancy and infiltration of the white matter of the spinal cord: 8 cases of fibrillary astrocytoma, 3 cases of gemistocytic astrocytoma, but one anaplastic and one case of pilocytic astrocytoma, oligoastrocytoma mixtum and anaplastic oligoastrocytoma.


RESULTS
Control MRI revealed a total removal of the lesion in 16 patients (70%), gross total removal in 5 patients (21%), partial removal in two patients (8%). Four patients died among those operated on: two in the perioperative period, the other two 9 months and 2 years after the surgery, respectively. In four patients there was observed regrowth of the lesion and one patient was re-operated on. In the second case fatal recurrence in region C2-Th6 was observed and the patient died, in the last two cases the patients were stable and thus it was decided to delay the re-operation.


CONCLUSIONS
Low mortality, morbidity and recurrence rates recommend surgery as an effective treatment for intramedullary gliomas.
Maliszewski
Mariusz
M
Katedra i Oddział Kliniczny Neurochirurgii w Sosnowcu, Slaska Akademia Medyczna, Sosnowiec. maliszewski_m@poczta.onet.pl
Majchrzak
Henryk
H
D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae; D002648:Child; D005260:Female; D005910:Glioma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013904:Thoracic Vertebrae; D016896:Treatment Outcome