title: [Surgical treatment of hemangioblastoma in medulla oblongata:a report of 12 cases].
abstract: OBJECTIVE
  To explore the clinical characteristics, diagnostic strategies and surgical techniques of hemangioblastoma (HB) in medulla oblongata.
  
  
  METHODS
  The clinical and radiological characteristics, therapeutic processes and outcomes of 12 HB cases treated at our department from 2002 to 2012 were studied by retrospective analysis.
  
  
  RESULTS
  Headache, somatic numbness and limb muscle weakness were the major symptoms of oblongata HB. Magnetic resonance imaging before surgery revealed a total of 12 single tumors. Among these tumors, upper (n = 1), middle (n = 7) and lower (n = 4) parts of medulla oblongata were involved. The locations were surface (n = 9) and intramedullary (n = 3). Three tumors had cyst. Digital subtraction angiography (DSA) was performed on 5 cases and it revealed that the main blood supply arteries of tumors were branches of posterior inferior cerebellar artery (PICA) and anterior inferior cerebellar artery (AICA).One case underwent pre-surgical embolism during angiography. Eleven tumors were totally resected and 1 was fulgurized.Symptoms improved (n = 8) and worsened (n = 2). And two patients died. All survivors were followed up for 3 months to 10 years and had a McCormick functional grading of I-II.One case relapsed 7 year later.
  
  
  CONCLUSIONS
  For Cystic HB, small or medium sized substantial HB in middle and lower part of oblongata, surgical removal is often safe and symptoms may be lessened.It can be used as a first-line treatment. For large ( ≥ 3 cm) substantial HB or HB in upper part of oblongata, serious postoperative complications such as respiratory failure, neurogenic pulmonary edema or acute obstructive hydrocephalus may occur. Thus surgical resection should be prudently considered and possible consequences thoroughly discussed with the patients.
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Ju-xiang
authors.initials: JX
authors.lastname: Chen
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. Email: lyc305@126.com.
authors.forename: Yi-cheng
authors.initials: YC
authors.lastname: Lu
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Guo-han
authors.initials: GH
authors.lastname: Hu
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Ke-hua
authors.initials: KH
authors.lastname: Sun
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Xue-hua
authors.initials: XH
authors.lastname: Ding
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Luo
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Wu
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Xu
authors.affiliation: Shanghai Neurosurgical Institute; Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000601:surgery*; D005260:Female; D018325:Hemangioblastoma / Q000601:surgery*; D006801:Humans; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult