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Surgical indication and technical considerations in the management of benign brain stem gliomas

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Summary

The treatment of brain stem gliomas has evolved over the last few decades, reflecting advances in imaging (MR), microsurgical techniques and biological understanding. The aim of this chapter is to provide a preoperative classification for intrinsic brain stem lesions that will predict histopathology and biological behavior from the clinical syndrome and the MR appearance. Such a classification system may help selecting children with brain stem tumors that can benefit from surgery. Technical considerations, potential surgical complications, and the ways to avoid them are discussed.

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References

  1. Lassiter KRL, Alexander E Jr, Davis CH: Surgical treatment of brain stem gliomas. J Neurosurg 34: 719–725,1971

    Google Scholar 

  2. Young JL, Miller RW: Incidence of malignant tumors in US children. J Pediatr 86: 254–258,1975

    Google Scholar 

  3. Littman P, Jarret P, L.T.B et al.: Pediatric brain stem gliomas. Cancer 45: 2787–2792,1980

    Google Scholar 

  4. Epstein F, Epstein N: Surgical treatment of spinal cord astrocytomas of childhood. A series of 19 patients. J Neurosurg 57:685–689,1982

    Google Scholar 

  5. Albright AL, Price RA, Guthkelch AN: Brain stem gliomas of childhood. A clinico-pathological study. Cancer 52:2313–2319, 1983

    CAS  PubMed  Google Scholar 

  6. Berger MS, Edwards MSB, La Masters D et al.: Pediatric brain stem tumors: radiographic, pathological and clinical correlations. Neurosurgery 12: 298–301,1983

    Google Scholar 

  7. Tomita T, McLone DG, Naidich TP: Brain stem gliomas in childhood. J Neuro Oncol 2: 117, 1984

    Google Scholar 

  8. Asai A, Hoffman HJ, Hendrick EB, Humphreys RP, Becker LE: Primary intracranial neoplasms in the first year of life. Childs Nervous System 5: 230–233,1989

    Google Scholar 

  9. Russell DS, Rubinstein LJ: Pathology of tumours of the nervous system. Williams and Wilkins, Baltimore, 1989

    Google Scholar 

  10. Pollack IF: Brain tumors in children. NEJM 331:1500–1507, 1994

    CAS  PubMed  Google Scholar 

  11. Rorke LB: Introductory survey of brain tumors. In: Cheek WR, Marlin AE, Mclone DG, Reigel DH, Walker ML (eds) Pediatric Neurosurgery, 3 edit. W.B. Saunders Company, Philadelphia, London, Toronto, Montreal, Sydney, Tokyo, pp 351–355,1994

    Google Scholar 

  12. Bailey P, Buchanan DN, Bucy P: Gliomas of The Brain Stem. The University of Chicago Press, Chicago, 1939

    Google Scholar 

  13. Dandy WE: Special Tumors of The Brain. Harper and Row, New York, 1962

    Google Scholar 

  14. Matson DD: Neurosurgery of Infancy and Childhood. 2. Charles C Thomas, Springfield, Illinois, 1969

    Google Scholar 

  15. Baker GS: Physiologic abnormality encountered after removal of brain tumors from the floor of the fourth ventricle. J Neurosurg 23:245–250,1964

    Google Scholar 

  16. Pool JL: Gliomas in the region of the brain stem. J Neurosurg 29:164–167,1968

    Google Scholar 

  17. Hoffman HJ, Becker L, Craven MA: A clinically and pathologically distinct group of benign brain stem tumors. Neurosurgery 7:243–248,1980

    Google Scholar 

  18. Albright AL, Guthkelch AN, Packer RJ et al.: Prognostic factors in pediatric brain stem gliomas. J Neurosurg 65: 751–755, 1986

    Google Scholar 

  19. Cohen ME, Duffner PK, Heffner RR, Lacey DJ, Brecher M: Prognostic factors in brainstem gliomas. Neurology 36: 602, 1986

    Google Scholar 

  20. Epstein F, McCleary L: Intrinsic brain stem tumors of childhood. J Neurosurg 64:11–15,1986

    Google Scholar 

  21. Stronik AR, Hoffman HJ, Hendrick EB et al.: Diagnosis and management of pediatric brain stem gliomas. J Neurosurg 65:745–750,1986

    Google Scholar 

  22. Epstein F, Wisoff J: Intra-axial tumors of the cervicomedullary junction. J Neurosurg 67: 483–487,1987

    Google Scholar 

  23. Alvisi C, Cerisoli M, Macheroni ME: Longterm results of surgically treated brain stem gliomas. Acta Neurochirurg 76:12–17,1985

    Google Scholar 

  24. Fasano VA, Urcioli R, Ponzio RM et al.: The effects of new technologies on the surgical management of brain stem tumors. Surg Neurol 25: 219–226,1986

    Google Scholar 

  25. Tokuriki Y, Handa H, Yamoshita J, Ohumura T, Paine JT: Brainstem glioma: An analysis of 85 cases. Acta Neurochir (Wien) 79: 67–73,1986

    Google Scholar 

  26. Epstein F: Intrinsic brain stem tumors of childhood. Surgical indications. In: Homburger F (ed) Progress in Experimental Tumor Research. edit. S. Karger, Basel 160–169,1987

    Google Scholar 

  27. Stroink AR, Hoffman HJ, Hendrick EB et al.: Transependymal benign dorsally exophytic brain stem gliomas of childhood: diagnosis and treatment recommendations. Neurosurgery 20:439–444,1987

    Google Scholar 

  28. Epstein F, Farmer JP, Schneider SJ: Intraoperative ultrasonography: an important adjunct for intramedullary tumors. J Neurosurg 74: 729–733,1991

    Google Scholar 

  29. Abbott R, Shiminski-Maher T, Wisoff JH, Epstein F: Intrinsic tumors of the medulla: Surgical complications. Pediat Neurosurg 17: 239–244,1992

    Google Scholar 

  30. Dam HP, Houidi K, Person H, Rodriguez V, Vallee B, Besson G: Contribution of ultrasonic cavitation — CO2 laser combination in the excision of panmedullary ependymoma. (Review) (French). Neurochirurgie 38: 376–380,1992

    Google Scholar 

  31. Vandertop WP, Hoffman HJ, Drake J: Focal midbrain tumors in children. Neurosurgery 31:186–194,1992

    CAS  PubMed  Google Scholar 

  32. Pierre-Kahn A, Hirsch JF, Vinchon M, Payan C, Sainte-Rose C, Renier D, Lelouch-Tubiana A, Fermanian J: Surgical management of brain-stem tumors in children: Results and statistical analysis of 75 cases. J Neurosurg 79: 845–852,1993

    Google Scholar 

  33. Bradac GB, Schorner W, Bender A, Felix R: MRI (NMR) in the diagnosis of brainstem tumors. Neuroradiology 27: 208–213, 1985

    Google Scholar 

  34. Lee BC, Kneeland JB, Walker RW, Posner JB, Cahill PT, Deck MD: MR imaging of brainstem tumors. AJNR 6:159–163, 1985

    Google Scholar 

  35. Byrne JV, Kendall BE, Kingsley DP, Moseley IF: Lesions of the brain stem assessment by magnetic resonance imaging. Neuroradiology 31:129–133,1989

    Google Scholar 

  36. Epstein FJ, Wisoff JH: Brain stem tumors in childhood. In: McLaurin RL, Schut L, Venes JL, Epstein F (eds) Pediatric Neurosurgery: Surgery of the Developing Nervous System. 2 edit. W.B. Saunders, Philadelphia, 1989

    Google Scholar 

  37. Barkovich AJ, Krischer J, Kun LE et al.: Brain stem gliomas: A classification system based on magnetic resonance imaging. Pediat Neurosurg 91: 73–83,1990

    CAS  PubMed  Google Scholar 

  38. Epstein FJ, Farmer JP: Brain-stem glioma growth patterns. J Neurosurg 78: 408–412,1993

    Google Scholar 

  39. Reigel DM, Scarff TB, Woodford JE: Biopsy for pediatric brain stem tumors. Child's Brain 5: 329–340,1979

    Google Scholar 

  40. Albright AL, Packer RJ, Zimmerman R, Rorke LB, Boyett J, Hammond GD: Magnetic resonance scans should replace biopsies for the diagnosis of diffuse brain stem gliomas: a report from the Children's Cancer Group. Neurosurgery 33: 1026–1030,1993

    Google Scholar 

  41. Wisoff JH, Epstein FJ: Surgical management of brain stem tumors of childhood and adolescence. Neurosurgeons 8: 115–123,1989

    Google Scholar 

  42. Chapman PH: Indolent gliomas of the midbrain tectum. Concepts in Pediatr Neurosurg 10: 97–107,1989

    Google Scholar 

  43. May PL, Blaser SI, Hoffman HJ, Humphreys RP, HarwoodNash DC: Benign intrinsic tectal ‘tumors’ in children. J Neurosurg 74: 867–871,1991

    CAS  PubMed  Google Scholar 

  44. Pollack IF, Pang D, Albright AL: The long-term outcome in children with children with late-onset aqueductal stenosis resulting from benign intrinsic tectal tumors. J Neurosurg 80:681–688,1994

    CAS  PubMed  Google Scholar 

  45. Squires LAMD, Allen JC, Abbott R, Epstein FE: Focal tectal tumors: Management and prognosis. Ped Neurosurg (in press), 1995

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, New York University Medical Center, USA

    Shlomi Constantini & Fred Epstein

  2. Department of Neurosurgery, Ichilov and Dana Medical Center, Tel-Aviv, Israel

    Shlomi Constantini

Authors
  1. Shlomi Constantini
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  2. Fred Epstein
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Constantini, S., Epstein, F. Surgical indication and technical considerations in the management of benign brain stem gliomas. J Neuro-Oncol 28, 193–205 (1996). https://doi.org/10.1007/BF00250199

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