Surgical Management of Intramedullary Hemangioblastoma of the Spinal Cord

Cristante, Loris; Herrmann, H. D.

doi:10.1007/s007010050308

Cited by 73 publications

(34 citation statements)

References 22 publications

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“…14 The prognosis of the hemangioblastoma patients was very good, and there were no deaths in our series. Previous studies have also reported high total tumor resection rates, in the range of 80-100%, [15][16][17] and total resection was possible in 11 (92%) of the 12 cases in our own series. The functional outcomes were also much better than those in the patients with ependymomas or astrocytomas, but because of the high possibility of persistent paresthesia and pain after surgery, it is most important to obtain preoperative informed consent.…”

Section: Discussionsupporting

confidence: 78%

Surgical treatment of intramedullary spinal cord tumors: prognosis and complications

et al. 2007

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Study design: Retrospective case series. Objective: To evaluate our recent treatment strategy for intramedullary spinal cord tumors. Setting: Department of Orthopaedic Surgery, Keio University, Japan. Methods: We reviewed 68 cases of intramedullary tumors (ependymoma, 33; astrocytoma, 23; hemangioblastoma, 12), treated surgically between 1994 and 2003. There were 42 males and 26 females whose mean age at the time of surgery was 43 years. The mean follow-up period was 6.2 years. The tumor malignancy grade according to the WHO classification was astrocytoma grade I, 3; grade II, 8 (low-grade: 11 cases); grade III, 10; grade IV, 2 (high-grade: 12 cases). All ependymomas were grade II. Three of the 12 hemangioblastomas were associated with von Hippel-Lindau disease. Results: Total excision was achieved in 90% of the ependymomas and functional improvement was obtained when the preoperative neurological deficit was mild. Approximately 50% of low-grade astrocytomas could be totally excised with favorable survival outcomes, suggesting that total excision should be attempted for low-grade astrocytomas. However, total excision of high-grade tumors was difficult and the functional outcomes were poor. Cordotomy should be considered in patients with a thoracic high-grade astrocytoma. Total resection was possible in 92% of hemangioblastoma, and the functional outcomes were good, however, more attention should be paid for tumors with feeding arteries on the ventral side and for those associated with von Hippel-Lindau disease. Conclusions: Predictors of good surgical outcome for intramedullary spinal cord tumors were histological grades of the tumors, surgical margins, and neurological status of the patient before surgery.

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Section: Discussionsupporting

confidence: 78%

Surgical treatment of intramedullary spinal cord tumors: prognosis and complications

et al. 2007

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“…A difference in neurological symptom was not observed between patients harboring sporadic hemangioblastomas and those harboring hemangioblastomas as a manifestation of VHL disease. Regards to the location of the tumor, intramedullary hemangioblastomas were reported as rare cases in previous review 4,18,20,26,28,30,32,[34][35][36] , but in our study intramedullary location (66%) was the most common.…”

Section: Discussioncontrasting

confidence: 47%

Spinal Cord Hemangioblastoma : Diagnosis and Clinical Outcome after Surgical Treatment

Kim²,

Eoh

et al. 2007

J Korean Neurosurg Soc

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“…This is similar to other series and suggests benefits in treating patients as soon as the diagnosis is made and before any neurological deterioration occurs. 4,7,9 When effective, surgical treatment should be able to maintain the patients' previous neurological status.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary hemangioblastomas: surgical results in 16 patients

Joaquim¹,

Ghizoni²,

Santos³

et al. 2015

FOC

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OBJECT Hemangioblastomas are rare, benign, highly vascularized tumors that can be found throughout the neuraxis but are mainly located in the cerebellum and in the spinal cord. Spinal hemangioblastomas can present with motor and sensory deficits, whose severity varies according to the size and location of the tumor. Resection is the best treatment option to avoid neurological deterioration. The authors report surgical results in the treatment of intramedullary hemangioblastomas and discuss the technical nuances important to achieving total resection without adding new deficits. METHODS A consecutive series of patients with intramedullary hemangioblastomas operated on between 2000 and 2014 by the senior author (H.T.) is presented. The functional scale proposed by McCormick was used to evaluate the patients' neurological status before and after surgery. RESULTS Sixteen patients were included in the study and underwent 17 surgeries. Follow-up was at least 6 months. Age at presentation varied from 13 to 58 years (mean 33.8 years). Ten patients (62.5%) were males and 6 patients (37.5%) were females. Seven (43.75%) of the 16 patients had associated von Hippel—Lindau syndrome, with hemangioblastomas also presenting in other locations. Three patients had multiple tumors in the same segment in the spinal cord, and 10 patients (62.5%) presented with cysts. According to the site of presentation, 11 tumors (68.75%) were localized at the cervical region (including the cervicomedullary junction) and 5 tumors (31.25%) at the thoracic level. Total resection was achieved in all cases, evidenced by postoperative MRI. Four patients had some functional worsening immediately after surgery. After 6 months, 1 patient had functional worsening compared with preoperative status, and 2 patients had clinical improvement. The majority of the patients remained clinically stable postoperatively. CONCLUSIONS Adequate knowledge of anatomy and the correct use of microsurgical techniques allowed total resection of these tumors, with minimal morbidity and maximum functional recovery. Outcome seems to be directly related to the neurological status before surgery.

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Surgical Management of Intramedullary Hemangioblastoma of the Spinal Cord

Cited by 73 publications

References 22 publications

Surgical treatment of intramedullary spinal cord tumors: prognosis and complications

Surgical treatment of intramedullary spinal cord tumors: prognosis and complications

Spinal Cord Hemangioblastoma : Diagnosis and Clinical Outcome after Surgical Treatment

Intramedullary hemangioblastomas: surgical results in 16 patients

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