title: Surgical resection of medulla oblongata hemangioblastomas: outcome and complications.
abstract: The purpose of this study was to analyze the surgical outcome and complications of a single-center series of medulla oblongata (MO) hemangioblastomas.
  
  
  
  We retrospectively reviewed the medical charts of all medulla oblongata hemangioblastomas operated on at our institution between 1996 and 2015. All patients had a pre- and postoperative MRI and a minimum follow-up of 6 months. Patients were scored according to the Karnofsky Performance Scale (KPS) and McCormick Scale at the moment of admission, discharge and the last follow-up.
  
  
  
  Thirty-one surgical procedures were performed on 27 patients (16 females and 11 males). The mean age was 33 years, and 93 % of patients had von Hippel Lindau (VHL) disease. Three patients experienced very complicated postoperative courses, with one case ending in the death of the patient. Two patients required tracheostomy. According to McCormick's classification, 7 (23 %) of the 31 operations resulted in aggravation and 23 (74 %) in no change. Considering the seven patients with aggravation at discharge, four patients (60 %) returned to their preoperative status, one (14 %) improved but remained below his preoperative McCormick grade and two (29 %) did not improve. At last follow-up, KPS was ameliorated in 53 %, stable in 40 % and worsened in 7 % of cases.
  
  
  
  Surgery of medulla oblongata hemangioblastomas is a challenging procedure characterized by an acceptable morbidity. Transient morbidity is not negligible even if the long-term outcome is in most cases favorable. A compromised neurological condition seems to be the best predictor of unfavorable outcome.
authors.affiliation: Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France. lore1985nch@gmail.com.|Department of Neurosurgery, Fondazione IRCCS "Istituto Neurologico C. Besta", Via. G. Celoria 11, Milan, 20133, Italy. lore1985nch@gmail.com.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Giammattei
authors.affiliation: Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.|Département de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Messerer
authors.affiliation: Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Nozar
authors.initials: N
authors.lastname: Aghakhani
authors.affiliation: Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: David
authors.affiliation: Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Herbrecht
authors.affiliation: Laboratoire de Génétique Oncologique EPHE, CHU de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Richard
authors.affiliation: Department of Neurosurgery, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D018325:Hemangioblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
keywords: Hemangioblastoma; Medulla oblongata; Surgical treatment; Von Hippel-Lindau syndrome