Clinical signs, diagnostics and surgical treatment results at patients with spinal hemangioblastomas
https://doi.org/10.17650/1683-3295-2013-0-3-15-23
Abstract
Objective: to optimize the surgical treatment strategy as well as to estimate the results of surgical treatment at patients with spinal hemangioblastomas. Material and methods: we operated 20 patients with solitary or multiple (von Hippel-Lindau syndrome) spinal hemangioblastomas - 12 men and 8 women from 2000 year till 2010 year. Multiple tumors because of von Hippel-Lindau syndrome were at 4 patients, idiopathic tumors - at 16 patients. Results: The temporary rising of neurological deficit after tumor removal was seen at 12 among 20 patients. There were no patients with small tumors (max size not more than 5 mm) who showed clinically significant deterioration of neurological status in postoperative period. The partial regress of neurological symptoms compared to preoperative status was seen at 6 patients, absence of neurological status dynamics - at 4 patients and deterioration of neurological signs - at 2 persons among all patients with larger tumors in postoperative periods. All patients remained within their functional class in spite of various dynamics of neurological status in postoperative period. Conclusion: the surgery is definitive mandatory for treatment of patients with solitary small hemangioblastomas located dorsally. The symptomatic spinal hemangioblastomas because of von Hippel-Lindau syndrome as well as solitary tumors are subjects to surgical removal. The open surgical treatment or radiosurgery may be proposed for solitary asymptomatic spinal hemangioblastoma. Multiple asymptomatic spinal hemangioblastomas are the indications for radiosurgery treatment.
About the Authors
D. V. Bublievsky
Первый МГМУ им. И.М. Сеченова
Russian Federation
Russian Federation
G. Ju. Evzikov
Первый МГМУ им. И.М. Сеченова
Russian Federation
Russian Federation
A. V. Farafontov
Первый МГМУ им. И.М. Сеченова
Russian Federation
Russian Federation
E. V. Shashkova
Первый МГМУ им. И.М. Сеченова
Russian Federation
Russian Federation
References
1. Евзиков Г.Ю., Крылов В.В., Яхно Н.Н. Хирургическое лечение внутримозговых спинальных опухолей. - М.: Гэотар-Медиа, 2006.
2. Зозуля Ю.А., Слынько Е.И. Спинальные артериовенозные мальформации: классификация, дифференцированная хирургическая тактика, результаты лечения // Український нейрохірургічний журнал., - 2005. - № 2.
3. Зозуля Ю.А., Слынько Е.И. Спинальные сосудистые опухоли и мальформации. - Киев: ООО УВПК «ЕксОб», - 2000.
4. Кушель В.Ю. Хирургия интрамедуллярных опухолей: анализ результатов, факторов риска и осложнений: автореф..дис.. д-ра мед. наук. - М., 2007.
5. Тиссен Т.П. Эндоваскулярное лечение артериовенозных мальформаций спинного мозга. - М, - 2006.
6. Яхно Н.Н., Евзиков Г.Ю., Егоров О.Е., Шашкова Е.В., Абдалова О.В. Спинальная гемангиобластома в сочетании с холокордом. Анализ особенностей клиники, диагностики и патогенеза сирингомиелии при интрамедуллярных опухолях // Неврологический журнал. - 2008. - 3(13). - С. 38-41.
7. Baker К.В., Moran C.J., Wippold F.J. et al. MR imaging of spinal hemangioblastomas // AJR Am J Roentgenol. - 2000. - 174. - Р. 377-382.
8. Bao-Cheng C., Satoshi T., Kazutoshi H., Matakazu F., Satoru A., Kazuo M. MR findings in spinal hemangioblastoma: correlation with symptoms and with angiographic and surgical findings // Am. J. Neuroradiol. - 2001. - 1(22). - P. 206-217.
9. Barbosa-Silva E. et al. Intradural extramedullary hemangioblastoma // Arq. Neuro-Psiquiatr. - 2009. - 67(2b). - P. 530-533.
10. Вiondia А. et al. Hemangioblastomas of the lower spinal region: report of four cases with preoperative embolization and review of the literature // Am. J. Neuroradiol. - 2005. - Apr: 26 (4). - P. 36 - 45.
11. Campos W.K., Linhares M.N. Sporadic Intramedullary Spinal Cord Hemangioblastoma in a Newborn. // Pediatr. Neurosurg. - 2010. - 46. - Р. 385-389.
12. Corr P., Dicker T., Wright M. Exophytic intramedullary hemangioblastoma presenting as an extramedullary mass on myelography // Am. J. Neuroradiol. - 1995. - 16. - P. 883-884.
13. Harati A., Satordd J., Mahler L., Billon-Grand R., Elsharkawy A., Niemeld M., Hernesniemi J. Early microsurgical treatment for spinal hemangioblastomas improves outcome in patients with von Hippel-Lindau disease. - Surg Neurol Int. - 2012. - 3(1). - P. 6-8.
14. Huang J.S., Chang C.J., Jeng C.M. Surgical management of hemangioblastomas of the spinal cord. - J.Formos. Med. Assoc. - 2003. - 102(12). - P. 868-875.
15. Joerger M., Koeberle D., Neumann H.P., Gillessen S. Von Hippel-Lindau disease - a rare disease important to recognize // Onkologie. - 2005. - 28(3). - P. 159-163.
16. Joon Ho Na et al. Spinal Cord Hemangioblastoma : Diagnosis and Clinical Outcome after Surgical Treatment // J Korean Neurosurg Soc. - 2007, Dec. - № 42(6). - Р. 436-440.
17. Kato M., Ohe N., Okumura A., Shinoda J., Nomura A., Shuin T., Sakai N. Hemangioblastomatosis of the central nervous system without von Hippel-Lindau disease: a case report // J. Neurooncol. - 2005. - 72(3). - P. 267-270.
18. Kiwitt J.C.W., Lanksch W.R., Fritsch H. Magnetic resonance tomography of solid spinal cord tumors with extensive secondary syringomyelia // Adv. Neurosurg. - 1988. - 16. - P. 211-215.
19. Malis L.I. Atraumatic bloodless removal of intramedullary hemangioblastomas of the spinal cord. // J.Neurosurg. - 2002. - 97 (11 Suppl). - P. 1-6.
20. Mehta G.U., Asthagiri A.R., Bakhtian K.D., Auh S., Oldfield E.H., Lonser R.R. Functional outcome after resection of spinal cord hemangioblastomas associated with von Hippel-Lindau disease // J Neurosurg. Spine. - 2010. - 12(3). - P. 233-42.
21. Patrice S.J. et al. Radiosurgery for hemangioblastoma: results of a multiinstitutional experience // Int. J. Radiat. Oncol. Biol. Phys. - 1996. - 35. - P. 493-499.
22. Pluta R.M., Iuliano B., DeVroom H.L., Nguyen T., Oldfield E.H. Comparison of anterior and posterior surgical approaches in the treatment of ventral spinal hemangioblastomas in patients with von Hippel-Lindau disease // J. Neurosurg. - 2003. - 98(1). - P. 117-124.
23. Solomon R.A., Stein B.M. Unusual spinal cord enlargement related to intramedullary hemangioblastoma // J. Neurosurg. - 1988. - 68. - P. 550-553.
24. Spetzler R.F. et al. Modified classification of spinal cord vascular lesions // J. Neurosurg. (Spine 2). - 2002. - 96. - P. 145- 156
25. Tibbs R.E. Jr., Harkey H.L., Raila F.A. Hemangioblastoma of the filum terminale: case report // Neurosurgery. - 1999. - 44(1). - P. 221-223.
Review
For citations:
Bublievsky D.V., Evzikov G.J., Farafontov A.V., Shashkova E.V. Clinical signs, diagnostics and surgical treatment results at patients with spinal hemangioblastomas. Russian journal of neurosurgery. 2013;(3):15-23. (In Russ.) https://doi.org/10.17650/1683-3295-2013-0-3-15-23
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