Operative management of brainstem hemangioblastomas.
Brainstem hemangioblastomas are technically challenging lesions. The authors retrospectively analyzed their experience in 24 patients with brainstem hemangioblastomas to evaluate the management strategies used over time and the results of microsurgical treatment. All patients were operated on between 2007 and 2012. The patients received postoperative follow-up by neuroradiological and neurological examinations. The maximum diameter of the tumors ranged from 2.0 to 4.5 cm (mean 3.6 cm). Gross total resection was achieved in 24 patients (100%). Two patients (8%) had new neurological deficits or worsening of pre-existing deficits. One patient (4%) died because of brain stem dysfunction after the operation. Radical en bloc surgical resection of brainstem hemangioblastomas in symptomatic patients is a safe and effective primary treatment. Preoperative embolization is not necessary. It is very important and necessary to differentiate and dissect precisely at the interface of the tumor surface and the brainstem with a meticulous microsurgical technique until the tumor is removed en bloc. The preoperative neurological status of the patient predicts the postoperative functional outcome. Asymptomatic patients with hemangioblastoma may be followed clinically with MRI surveillance at regular intervals.
Department of Neurosurgery, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China.
Li-feng
LF
Chen
Yang
Y
Yang
Xin-guang
XG
Yu
Bo
B
Bu
Bai-nan
BN
Xu
Ding-biao
DB
Zhou
D000293:Adolescent; D000328:Adult; D020295:Brain Stem Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D018325:Hemangioblastoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
Brain stem; Hemangioblastoma; Microsurgery