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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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Surgery of posterior cranial fossa gliomas in childhood

Meeting Abstract

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  • R. Popov - Department of Neurosurgery, Medical University, Sofia, Bulgaria
  • Y. Enchev - Department of Neurosurgery, Medical University, Sofia, Bulgaria
  • L. Laleva - Medical University Sofia, Bulgaria
  • T. Spiriev - Medical University Sofia, Bulgaria
  • M. Marinov - Department of Neurosurgery, Medical University, Sofia, Bulgaria
  • V. Bussarsky - Department of Neurosurgery, Medical University, Sofia, Bulgaria

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.08-01

doi: 10.3205/09dgnc044, urn:nbn:de:0183-09dgnc0448

Published: May 20, 2009

© 2009 Popov et al.
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Outline

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Objective: Gliomas of the posterior cranial fossa in childhood nowadays still represent surgical challenge, especially those engaging the brain stem. The aim of this study was to analyze our surgical experience with these tumours.

Methods: Forty two consecutive children with posterior fossa gliomas operated on between January 2004 and September 2008 in the Clinic of Neurosurgery at University Hospital „Sv. Ivan Rilsky“ were reviewed. The median age was 8 years (range, birth-18 yrs). The male:female ratio was 19:23. Headache, nausea and vomiting were the most frequent onset symptoms (ICP-31 pts). The most common findings were VI-th cranial nerve palsy (13 pts), ataxia and hemiparesis. The tumour in 29 cases engaged the brain stem.

Results: Gross total resection was performed in 12 children (28.5%), subtotal resection in 5 (12%), partial resection in 12 (28.5%) and biopsy in 6 patients (14%). The rest 7 cases underwent only neuroendoscopic third ventriculostomy (5 pts or 12%) or implantation of ventriculo-peritoneal anastomosis (2 pts or 5%). The histologically confirmed gliomas were low grade in 79% and high grade in 21%. In the early postoperative period favourable clinical outcome was defined in 31 patients, morbidity was 7% (3 pts) and mortality 7% (3 pts).

Conclusions: The degree of posterior fossa gliomas resection in childhood is highly dependent on the size and localization of the tumour, as the main restricting factor is the brain stem engagement. The surgical morbidity may be limited by the application of neuroendoscope and by minimizing the brain retraction and coagulation.