Surgical Approaches to Thalamic Tumors


Authors: M. Smrčka 1;  E. Brichtová 2;  Z. Mackerle 2;  V. Juráň 1;  V. Přibáň 1,3
Authors‘ workplace: Neurochirurgická klinika LF MU a FN Brno 1;  Klinika dětské chirurgie, ortopedie a traumatologie LF MU a FN Brno 2;  Neurochirurgická klinika LF UK a FN Plzeň 3
Published in: Cesk Slov Neurol N 2015; 78/111(2): 172-180
Category: Original Paper

Overview

Introduction:
Thalamic tumours are relatively rare lesions growing in a highly functional part of the brain. They are more frequent in paediatric population. Their surgery is challenging and associated with a risk of significant morbidity. Relatively benign nature of many of these tumours suggests that radical resection should be attempted. The approach has to be very carefully planned, sometimes with help of modern diagnostic methods such as DTI. Location and projection of the tumour in the thalamus plays an important role in selecting an approach.

Material and methods:
During 2005–2014 we operated on 13 patients with thalamic tumours, mean age 20.6 years (1–64 years). These were 10 males and three females. Another 15-year-old male patient is being observed. Transcortical approach was used 7×, transcallosal 4×, transsylvian 2× and supracerebellar infratentorial 1×.

Results:
Gross total resection was achieved in six cases, subtotal in four and partial in three. There were eight pilocytic astrocytomas, one subependymal giant cell astrocytoma, one diffuse astrocytoma G II and three glioblastomas. Two older patients with glioblastomas died six and nine month after operation. All other patiens are still alive with the mean follow-up 5 years. Neurological status after the operation was good except for one older patient with glioblastoma who developed severe hemiparesis and aphasia.

Conclusion:
Thalamic tumours might be safely radically resected if correct approach is used. The choice of approach is based on the projection of the tumour. Smaller tumours that are not reach thalamic surface might be followed up or biopsied if there is a likelihood of their malignant nature. Oncological treatment should be reserved to malignant tumours.

Key words:
thalamic tumours – surgical approaches

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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