title: Surgical management of intracranial subependymomas.
abstract: BACKGROUND
  Intracranial subependymomas are rare, slow-growing and usually non-invasive tumors. The aim of this study was to analyze our experience with the surgical treatment of intracranial subependymomas.
  
  
  METHODS
  Between 1991 and 2007, 11 patients with intracranial subependymomas had surgery in our institution. Mean age of the patients was 54.4 years (ranging from 40 to 85 years).
  
  
  RESULTS
  Tumors were located in the fourth ventricle in seven patients and in the lateral ventricle in four patients. Most patients presented with symptoms related to intracranial hypertension and/or cerebellar signs and symptoms (headache: eight patients; dizziness: six patients; nausea: six patients; gait ataxia: four patients), one patient with cognitive decline and flattened affect, and one patient with a hemiparesis. Six patients presented with hydrocephalus, but only one needed a permanent cerebrospinal fluid (CSF) shunt. Complete removal of the tumor was possible in eight cases. Following surgery, only one patient experienced a permanent drop of his Karnofsky Performance Index (from 70 to 60). Median follow-up was 37 months. There were no true recurrences during follow-up. A second surgery was required 7 years after the first operation for progression of an incompletely resected tumor.
  
  
  CONCLUSIONS
  Removal of symptomatic subependymomas can be performed safely. Prognosis is excellent after a complete resection. The potential for a surgical cure, low surgical complication rates and the risk of undertreatment of a more aggressive tumor together may justify surgery for asymptomatic lesions.
authors.affiliation: Neurochirurgische Klinik, Universitätskliniken Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. julia.kandenwein@hotmail.de
authors.forename: Julia Annabel
authors.initials: JA
authors.lastname: Kandenwein
authors.forename: Azize
authors.initials: A
authors.lastname: Bostroem
authors.forename: Mareike
authors.initials: M
authors.lastname: Feuss
authors.forename: Torsten
authors.initials: T
authors.lastname: Pietsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Simon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002551:Cerebral Ventricle Neoplasms / Q000473:pathology / Q000601:surgery*; D002552:Cerebral Ventricles / Q000473:pathology / Q000601:surgery*; D005260:Female; D018315:Glioma, Subependymal / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D014696:Ventriculostomy / Q000379:methods*