Treatment of Intramedullary Hemangioblastomas, with Special Attention to von Hippel-Lindau Disease

Velthoven, Vera Van; Reinacher, Peter C.; Klisch, Joachim; Neumann, Hartmut P. H.; Gläsker, Sven

doi:10.1227/01.neu.0000093497.81390.29

Cited by 88 publications

(79 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We agree with these authors, although nowadays MRI has become the diagnostic method of choice and is recommended by several authors in the diagnosis of hemangioblastomas [1,[8][9][10]. However in the diagnosis of the feeding and draining vessels of intramedullary tumors, MRI technique is still insufficient and, therefore, in our opinion DSA is mandatory for a successful and safe microsurgical treatment.…”

Section: Discussionsupporting

confidence: 74%

“…Intramedullary hemangioblastomas are rare lesions and there are not many reports about the microsurgical removal in larger series [3,10,12]. They have been considered to pose severe problems during surgery because of the risk of massive bleeding [3].…”

Section: Discussionmentioning

confidence: 99%

“…The entity of a tumor-associated cyst or syrinx has been reported to be present between 50 and 80% [6,7,10]. Only one author reported in his series a smaller proportion with 16% [3].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the recently published series recommend microsurgical removal in symptomatic patients or in cases with tumor growth during follow-up [3,7,10]. The authors reviewed their data of 23 consecutive patients with respect to timing of surgery, microsurgical technique, and follow-up.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intramedullary hemangioblastomas: timing of surgery, microsurgical technique and follow-up in 23 patients

et al. 2008

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

“…The entity of a tumor-associated cyst or syrinx has been reported to be present between 50 and 80% [6,7,10]. Only one author reported in his series a smaller proportion with 16% [3].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intramedullary hemangioblastomas: timing of surgery, microsurgical technique and follow-up in 23 patients

et al. 2008

View full text Add to dashboard Cite

show abstract

“…2 gave a figure of 13.9% for ependymomas, Liang et al 35 of 6.2% for cavernomas, Lu and Lawton 36 of 9% for cavernomas, Mehta et al 44 of 4% for angioblastomas, and Van Velthoven et al 59 of 0% for angioblastomas. In this study, rates for permanent morbidity also varied according to histology and were lowest for angioblastomas and cavernomas but highest for ependymomas similar to these literature reports.…”

Section: Permanent Surgical Morbiditymentioning

confidence: 95%

Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results

Klekamp

2013

SPI

109

View full text Add to dashboard Cite

Object Surgery of intramedullary tumors is established as the treatment of choice for these challenging lesions. This study presents a detailed analysis of risk factors for surgical morbidity and data on long-term results for intramedullary tumors. Methods Among 1317 patients with tumors of the spinal canal treated between 1980 and 2012, 278 patients with intramedullary tumors are presented. A total of 225 of these patients underwent 246 operations for treatment of 250 tumors. The mean patient age was 41 ± 17 years (range 3 weeks to 83 years). Patients underwent follow-up through outpatient visits and questionnaires with a mean follow-up of 41 ± 53 months. Tumors were subdivided into 3 groups: displacing tumors (Type A, n = 162), infiltrating tumors (Type B, n = 80), and nonproliferating tumors (Type C, n = 8). A gross-total resection (GTR) was attempted for every tumor except for Type C lipomas. Participating surgeons were divided into 3 groups according to the number of operations they performed. Short-term results were determined for individual symptoms and the modified McCormick Scale, whereas tumor recurrence rates were calculated with Kaplan-Meier statistics. Results Overall, 83.3% of Type A tumors underwent GTR compared with 22.5% of Type B and none in Type C. Gross-total resection rates increased throughout the study period and correlated significantly with surgical experience. A worsened neurological state after surgery was seen in 61% of patients. This deterioration was transient in 41.5% and was a common observation after GTR. Permanent morbidity (19.5%) was lowest after GTR and correlated significantly with surgical experience and the preoperative neurological state. Further analysis showed that patients with tumors of thoracic levels, tumor hemorrhages, and malignant and recurrent tumors were at a higher risk for permanent morbidity. In the long term, tumor recurrence rates for ependymomas and benign astrocytomas correlated significantly with the amount of resection. Long-term morbidity affected 3.7% with a postoperative myelopathy related to cord tethering at the level of surgery and 21.9% in form of neuropathic pain syndromes. The rate of postsurgical cord tethering could be lowered significantly by using pia sutures after tumor resection. Neuropathic pain syndromes were more common after surgery for tumors with associated syringomyelia or those located in the cervical cord. Conclusions Intramedullary tumors should be surgically treated as soon as neurological symptoms appear. Gross-total resection is possible for the majority of benign pathologies. Cervical tumors are associated with higher GTR and lower permanent morbidity rates compared with thoracic tumors. Surgery on intramedullary tumors should be performed by neurosurgeons who deal with these lesions on a regular basis as considerable experience is required to achieve high GTR rates and to limit rates of permanent morbidity.

show abstract

Intraoperative sonographically guided resection of hemangioblastoma in the cerebellum

Wang¹,

Wang²,

Gao³

et al. 2006

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

Treatment of Intramedullary Hemangioblastomas, with Special Attention to von Hippel-Lindau Disease

Cited by 88 publications

References 31 publications

Intramedullary hemangioblastomas: timing of surgery, microsurgical technique and follow-up in 23 patients

Intramedullary hemangioblastomas: timing of surgery, microsurgical technique and follow-up in 23 patients

Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results

Intraoperative sonographically guided resection of hemangioblastoma in the cerebellum

Contact Info

Product

Resources

About