Extracerebral tumors of posterior fossa often lead to dysfunction of the brain stem, however the degree of brain stem’s damage is determined most often on the basis clinical data only. Magnetic Resonance Spectroscopy (MRS) allows to study biochemical processes and determine chemical content of the cerebral tissues noninvasively. Changes in brain stem’s perifocal zone in patients with acoustic neuromas and subtentorial meningiomas have been studied. Basic metabolite’s level’s analysis of N-acetyl-asparatate (NAA), creatine, choline and lactate have been conducted. Changes in brain stem’s metabolism depend on duration of the disease and the conditions of the patient on admission have been revealed. However the change in metabolite’s level and their role in the brain in case of pathology and in normal conditions need further investigations.
Metastatiс spread of neoplasms to the pituitary gland is a relatively common finding in autopsy series of cancer patients. The majority of these patients were asymptomatic. Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland. From 1993 through 2008, 3 patients with symptoms arising from tumor metastasis to the pituitary gland were evaluated at the Russian Polenov Neurosurgical Institute.Breast and lung cancers are the most common diseases that metastasize to the pituitary.In two patients, the primary malignancy was breast. In one case, the primary tumor was lung. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia were the most commonly reported symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved.
The article presents review of literature for spinal tumors most common in practice. Intraoperative tumor description, histological verification and tactics are presented. Totality of resection of lesion, and methods of instrumentation in case of vertebral column instability are discussed. In spite of lot of the literature, adequate decision is very hard in case of spinal cord and vertebral tumor. Severity of disease is burdened with concomitant somatic symptomatology, neglect of disease, dissemination of the process, vertebral metastases in case of unoperated primary tumor. According to histology, dissemination and vertebral lesion, each definite case should be examined individually and in complex. Only the surgical method is not enough for the decision of spinal tumor problem.
Visual functions in the postsurgical period are among the most important factors determining the quality of life in patients with tumors of sellar region. Advances in surgical treatment of patients with sellar tumors require exact evaluation of degree the optic nerves and chiasm being involved in the pathological process. The problem of approapriate surgical treatment cannot be solved without its consideration in the neuroophthlmological aspect. The main purpose of intra-operative monitoring of visual evoked potentials is well-timed revealing and prevention of damage of the visual system.
The aim of the research is to investigate activation of antitumor immune response efficiency using professional antigen-presenting autologous dendrite cells in the complex treatment of patients with cerebral hemisphere malignant gliomas. We have analysed 48 cases of patients with malignant gliomas (35 — glioblastoms, 13 — anaplastic astrocytoma) who received an complex treatment with specific immunotherapy use. All the patients were hospitalized at late stage of disease and tumor size exceeded 5 sm. After the operation all the patients achieved satisfactory quality of life (not less than 80 points according to Karnofsky). Specific antitumor immunotherapy was conducted in accordance with original methodic, including autologous dendrite cells with tumor antigens and tumor cells lysate. Treatment course included intradermal introduction of dendrite cells at the 10—12 day after the operation. The treatment included not less than 3 injections. The course of treatment was repeated every 2—3 months. Specific antitumor immunotherapy included into complex treatment of malignant gliomas allows to increase disease remission, life quality being satisfactory.
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