title: Management of intramedullary tumors in children: analysis of 82 operated cases.
abstract: BACKGROUND
  Intramedullary tumors are rare and comprise only a small percentage of all central nervous system neoplasms. There has been much controversy with the surgical management of these tumors. This study presents detailed information regarding clinical presentation, histological findings, outcomes, functional assessment, and management of a series of patients with this diagnosis.
  
  
  METHODS
  The authors reviewed 82 cases of up to 18 years of age operated between 2001 and 2010. The symptomatology, neurological and neuroradiological findings, operative details, perioperative and postoperative complications, histopathological data, and follow-up examinations were studied and analyzed.
  
  
  RESULTS
  There were 57 (69.5 %) males and 25 (30.4 %) females. Overall, epidermoid (20.7 %) constituted the most common tumor followed by low-grade gliomas and ependymoma (19.5 % each). Near total resection for epidermoid and dermoid was possible in 82.3 % and 60 % cases, respectively. Ependymomas were more amenable for gross total excision (43.7 %) as compared to pilocytic astrocytomas (22.2 %); however, near total resection was possible in another 50 % and 66.6 % cases, respectively. At the last clinical evaluation on follow-up, 8 patients (14.2 %) had improved in their grades, 46 patients (82.1 %) remained unchanged, and 2 patients (3 %) worsened.
  
  
  CONCLUSIONS
  Complete removal of the lesion is the primary goal. In our experience, we conclude that the strongest predicting factor of functional outcome was the preoperative neurological condition beyond the histological differentiation of the intramedullary tumors.
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India. drsumitbansal@gmail.com
authors: Sumit
authors: S
authors: Bansal
authors: Ashish
authors: A
authors: Suri
authors: Sachin A
authors: SA
authors: Borkar
authors: Shashank Sharad
authors: SS
authors: Kale
authors: Manmohan
authors: M
authors: Singh
authors: Ashok Kumar
authors: AK
authors: Mahapatra
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D016343:Monitoring, Intraoperative; D018908:Muscle Weakness / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009422:Nervous System Diseases / Q000209:etiology; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D018714:Radiotherapy, Adjuvant; D013120:Spinal Cord Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome