Pediatric intrameduUary spinal cord tumors occur infrequently with limited data on treatment strategies and outcome. Over an 11-year period, 44 patients with such tumors who were primarily managed by radical surgery were retrospectively reviewed. The majority of tumors (42/44, 95%) were in the cervical or thoracic spine and were histologically low grade. Gross total resection was achieved in 73% (32/44). At a median follow-up of 45 months, 11 % (5/44) had severe weakness (modified McCormick scale IV–V), 66% (29/44) had mild-moderate deficits (I–III), and 16% (7/44) had sphincter dysfunction. Tumor recurrence rate was 18% (8/44) after a mean period of 54 months. Age, number of involved spinal cord segments and extent of surgical resection did not significantly impact on tumor recurrence rates (p = 0.28, 0.44 and 0.13, respectively). The only significant prognostic factor was histological type; mixed or higher grade tumors having a higher recurrence rate (p = 0.04). Radical surgery for intraspinal tumors can achieve long tumor-free survival without requiring adjuvant therapy.
Glucose detection using Glucostix test strips is not recommended as a confirmatory test due to its lack of specificity and sensitivity. In the presence of a skull bas fracture on CT and a clinical CSF leak, there is no need for a further confirmatory test. In cases where a confirmatory test is needed, the beta-2 transferrin assay is the test of choice because of its high sensitivity and specificity.
Objective-Primary brain tumours may be associated with coagulation disorders which can pose intraoperative and postoperative management diYculties. The aim was to evaluate the coagulation profile of patients with brain tumours undergoing surgery using thromboelastography (TEG) in combination with simple laboratory tests.
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