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Rehabilitation of Central Nervous System Tumors; Palliative Care in Neuro-Oncology; Imaging: Functional Neuroanatomy; Surgical Navigation; Stereotactic Brain Biopsy; Intraoperative Anatomical Imaging; Intraoperative Molecular Imaging; Intraoperative Functional Mapping; Endoscopy; Procedures: Transsphenioidal; Spinal Neoplasms; Spinal Cord Tumors; Low Grade Gliomas; Pineal Gland Tumors; Intraventricular Tumors; Insular Tumors; Pediatric Tumor Surgery; General Principles; Medical Management of Supratentorial Gliomas in Adults; Medical Management for Pediatric Gliomas; Medical Management of Primitive Neuroectodermal Tumors; Intracranial Meningiomas; Medical Management for Brainstem Tumors; Tumors of the Pituitary and Sellar Region; Medical Treatment of Spinal Cord Tumors; Brain Metastases and Leptomeningeal Disease; Primary Central Nervous System Lymphoma; General Principles of Targeted Therapies; General Principles of Angiogenesis; Biologics; Other Therapies; Introduction to Radiation Therapy; Supratentorial Gliomas: Radiation for Glioblastoma; Anaplastic Glioma; Low-Grade Glioma Radiation Therapy; Ganglioglioma; Optic Pathway Glioma; Medulloblastoma and Primitive Neuroectodermal Tumors; Ependymoma Intracranial ; Vestibular Schwannoma; Hemangioblastoma and Hemangiopericytoma; Radiation Therapy for Intracranial Meningiomas; Adult and Pediatric Brainstem Glioma; Pituitary Tumors and Craniopharyngioma; Neurocytoma; Edited By: Dwight E.
Herman MD, MSc. Patrick Y. Springer Publishing Company Proudly serving the health care and helping professions. Welcome to Springer Publishing! Shopping Cart 0. Close Recently added item s You have no items in your shopping cart. Administration, Management, and Leadership. Advanced Practice Nursing. Board Review and Certification. Cherry Ames Series. Community Health Nursing. Complementary, Integrative, and Alternative Medicine. Critical Care and Emergency. Fast Facts Series. Geriatric and Gerontological.
Tumor Neurosurgery: Principles and Practice - Google Livres
Maternal, Neonatal, Women's Health. MedSurg and Acute Care Nursing. Nursing Education. Nursing General Interest. Palliative Care and End-of-Life. Pediatric Nursing. Professional Issues and Trends. Psychiatric Nursing. Research, Theory, and Measurement. Undergraduate Nursing. Watson Caring Science Institute. Browse All. Between January and August , children were surgically treated for an intracranial neoplasm at the VUmc Amsterdam, the Netherlands. In the remaining children, craniotomies were performed. All data were collected by retrospectively reviewing patient medical records.
All patients were examined in detail, pre- and postoperatively, by pediatricians, pediatric neurologists, and neurosurgeons, and all patients had previously undergone a complete investigative work-up with computed tomography CT , magnetic resonance MR scan, or both. Surgical techniques included image-guided microsurgery, ultrasonic aspiration, ultrasound tumor localization, and cortical mapping, with the individual cases dictating the techniques required.
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Each surgical procedure was attended by one of the senior pediatric neurosurgeons. The objectives of surgery were maximal possible resection of the tumor with optimal neurological outcome.
Each type of tumor was graded and specified according to the WHO classification [ 11 ]. The histopathological diagnosis and age determined which adjuvant therapies, such as radiotherapy and chemotherapy, were given. Residual or recurrent tumors during follow-up were resected second or a third craniotomy if they showed radiological progression or when they caused symptoms. Complications were classified into seven groups: none, neurological, endocrinological, infectious, cerebrospinal fluid CSF disturbances, postoperative hematoma, and other. We specified the endocrinological complications for different tumor locations.
In cases of CSF disturbances, shunt dependency was classified as a long-term complication. Causes of postoperative hematoma and their consequences were analyzed by reviewing the surgical reports. For all deceased patients, the cause of death was established. Since WHO classification and the extent of surgical resection are both associated with survival [ 14 , 22 ], we analyzed our survival data using a Log Rank trend test.
Separate Kaplan—Meir curves were made to visualize survival functions. All analyses were conducted with statistical software SPSS A literature search of the National Library of Medicine database Pubmed; —the present was conducted in May , using subject headings MeSH and keywords and limited to human studies.
Publications written in a language other than English, Dutch, French, or German were excluded, as were abstracts, editorials, letters, comments, or publications before The abstracts were reviewed, and articles unrelated to the specific topic were excluded. Duplicate references, as well as redundant publications, were discarded.
Using these research criteria, all studies considered eligible were retrieved, and the final selection was based on the full article. To identify additional eligible studies, the reference lists were also screened for journal articles.
An analysis of the published studies concerning surgical morbidity and mortality for pediatric brain tumors was performed. The data extraction included the following parameters: 1 year of publication and author, 2 number of reported patients, 3 reported surgical morbidity and mortality, 4 types of surgery studied, 5 histopathological types and location of tumors diagnosed, 6 extent of resection, and 7 duration of follow-up. There were 70 boys and 51 girls, for a male-to-female ratio of 1.
The mean age at the time of first surgery was 8. All patients underwent primary surgery, 14 patients had a second surgery, and two patients underwent a third surgery for a total of operations. Summary of cases with respect to diagnosis, extent of surgery, and WHO classification. Multiple complications could occur in one single patient. In Fig.
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Specification and number of neurological complications after first surgery. ICP intracranial pressure. Operative endocrinological complications included diabetes insipidus, panhypopituitarism, hypothyroidism, hypo- and hypercortisolism, hypokalemia, hypernatremia, and cerebral salt wasting. Except for patients with panhypopituitarism and hypothyroidism, all endocrinological complications were short-term.
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In cases of panhypopituitarism and hypothyroidism, patients still have hormone replacement therapy, and these complications are therefore classified as long-term. Specification, number, and tumor location of short-term endocrinological complications after first surgery. Specification, number, and tumor location of long-term endocrinological complications after first surgery. The surgical infectious complications consisted of meningitis, urinary tract infections, and wound infections and were all short-term.
In five cases, a postoperative hematoma occurred.
One patient had a postoperatively discovered epidural hematoma caused by a temporal bone fracture due to using the Mayfield clamp. This patient needed a second emergency surgery to remove the hematoma and made an uneventful recovery. In another patient, the postoperative hematoma was located in the brain stem and caused brain stem dysfunction.
In the other three cases, a hematoma was found on postoperative imaging and was treated by drainage. Again, multiple complications could occur in one single patient.
The sole endocrinological complication was a short-term diabetes insipidus. The patient with a CSF disturbance became shunt-dependent. There were two tertiary operations. After the third craniotomy for recurrent disease, the patient was discharged without any postoperative neurological deficits. At follow-up, a slight hemiparesis on the right side and periods of epileptic insults were observed. The hemiparesis worsened, and a severe dyspraxia is present. A postoperative partial epileptic seizure occurred, after which, a long-term speech disturbance and visual deficits on the right side remained.
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