Summary
In most cases of brain stem expansive lesion a surgical approach is possible, but in each patient it must be evaluated if the surgical risk is proportional to the therapeutic result. Sometime surgery is limited to a biopsy sample, particularly in malignant lesions. We started stereotactic serial biopsy sampling in all CT or NMR intra-axial brain stem expansive lesions as a preliminary diagnostic procedure. The aim is to look for benign well delimited lesions that we consider for surgical removal or to drain haematomas and abscesses.
35 patients with brain stem expansive lesions were submitted to 47 surgical procedures: 35 stereotactic biopsies (one each patient) and, among them, 12 were major surgical procedures (with craniotomy) for microsurgical removal of the expansive lesions. 15 patients were in paediatric age.
Suboccipital transcerebellar approach was performed in 25 mesencephalic, pontine, bulbar expansive lesions and frontal approach was limited to 10 thalamo-mesencephalic lesions. There was no mortality. Two patients were stereotactically drained and definitively cured.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Albright AL, Sclabassi RJ (1985) Use of the Cavitron ultrasonic surgical aspirator and evoked potentials for the treatment of thalamic and brain stem tumours in children. Neurosurgery 17: 564–568
Apuzzo MJ, Sabshin JK (1983) Computed tomographic guidance stereotaxis in the management of intracranial mass lesions. Neurosurgery 12: 277–285
Baghai P, Vries JK, Bechtel PC (1982) Retromastoid approach for biopsy of brain stem tumours. Neurosurgery 10: 574–579
Broggi G, Franzini A, Migliavacca F, Allegranza A (1983) Stereotactic biopsy of deep brain tumours in infancy and childhood. Child’s Brain 10: 92–98
Broggi G, Franzini A, Giorgi C (1983) The value of stereotactic biopsy in management of brain stem lesions. Ital J Neurol Sci [Suppl] 21: 51–56
Coffey RJ, Lunsford LD (1985) Stereotactic surgery for mass lesions of the midbrain and pons. Neurosurgery 17: 12–18
Franzini A, Ferraresi S, Giorgi C, Allegranza A, Broggi G (1987) La biopsia stereotassica nel trattamento delle lesioni espansive del tronco cerebrale. In: B Cucciniello Attualita’ in Neurochirurgia 1987: 23–27
Halperin EC (1985) Paediatric brain stem tumours: Patterns of treatment failure and their implications for radiotherapy. Int J Radiat Oncol Biol Phys 11: 1293–1298
Heppner F, Oberbauer RW, Ascher PW (1985) Direct surgical attack on pontine and rhombencephalic lesions. Acta Neurochir (Wien) [Suppl] 35: 123–125
Mathisen JR, Giunta F, Marini G, Backlund E-O (1987) Transcerebellar biopsy in the posterior fossa: 12 years experience. Surg Neurol 27: 297–299
Murphy MG (1972) Successful evacuation of acute pontine haematoma: case report. J Neurosurg 37: 224–225
Niizuma H, Suzuki J (1987) Computed tomography-guided stereotactic aspiration of posterior fossa haematomas: a supine lateral retromastoid approach. Neurosurgery 21: 422–427
Ravetto F, Di Cagno L, Bosco M, Madon E, Gajno TM (1979) I tumori infiltranti del tronco encefalico in eta’ evolutiva. Min Ped 31: 95–110
Russell B, Rengachary SS, McGregor D (1986) Primary pontine haematoma presenting as a cerebellopontine angle mass. Neurosurgery 19: 129–133
Soffer D, Sahar A (1982) Cystic glioma of the brain stem with prolonged survival. Neurosurgery 10: 499–502
Stroink AR, Hoffman HJ, Hendrick EB, Humphreys RB (1986) Diagnosis and management of paediatric brain stem gliomas. J Neurosurg 65: 745–750
Van Gilder JC, Allen WE, Lesser RA (1974) A pontine abscess: survival following surgical drainage: case report. J Neurosurg 40: 386–390
Villani R, Gaini SM, Tornei G (1975) Follow-up of brain stem tumours in children. Childs Brain 1: 126–135
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1989 Springer-Verlag
About this paper
Cite this paper
Giunta, F., Grasso, G., Marini, G., Zorzi, F. (1989). Brain Stem Expanding Lesions: Stereotactic Diagnosis and Therapeutical Approach. In: Broggi, G., Burzaco, J., Hitchcock, E.R., Meyerson, B.A., Tóth, S. (eds) Advances in Stereotactic and Functional Neurosurgery 8. Acta Neurochirurgica Supplementum, vol 46. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9029-6_21
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9029-6_21
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-9031-9
Online ISBN: 978-3-7091-9029-6
eBook Packages: Springer Book Archive