Early results of stroke-like supratentorial tumors surgical treatment
Objective – to study early results of surgical treatment in 176 patients with supratentorial tumors (ST) with a stroke-like course.
Materials and methods. The results of surgical treatment of 176 patients with stroke-like tumors were studied. They were treated at the urgent neurosurgery clinic of the Kyiv Emergency Hospital during the period from 2008 to 2015. The age of the patients was 20-70 years, the average age was (53.7 ± 13.4) years. There were 104 (59.1 %) men, 72 (40.9 %) women. Intracerebral tumors were diagnosed in 156 (88.6 %) cases, metastasis was observed in 35 (19.9%), 20 (11.4 %) patients have extracranial tumors Patients were divided into two groups depending on cerebrovascular accident: the group I – 103 patients had hemorrhagic type of cerebrovascular accident, the group II – 73 patients had ischemic type of cerebrovascular accident. In early postoperative period, CT and/or MRI was performed in all cases to detect postoperative complications and evaluate the radicality of surgical resection. An ophthalmologic review before and after surgery was performed.
Results. Total resection was achieved in 68 (38.6 %) patients, near total – in 82 (46.6 %), subtotal – in 26 (14.8 %). All 176 patients had less than 70 points of Karnovsky scale before surgery, after treatment the number of this patients decreased to 36 (20.5 %) patients. Improvement of quality life was noted in regression of neurological deficits, restoration of functional disorders, high degree of social adaptation.
Conclusions. The main criteria of successful surgical treatment of tumors with stroke-like course. is the survival of patients with radical surgical resection and satisfactory quality of life in the postoperative period. Factors that influence the removal of the tumors with stroke-like course are size of the lesion, its localization, and the histological characteristics of the tumors. Therapeutic tactics in patients with tumors with stroke-like course should be based on an individual approach. Adequate surgical removal of the tumors and hematomas evacuation improve the quality of life in most patients (79.5 %).
Badve C, Rogers LR. Intracranial hemorrhage in cancer patients. Handbook of neuro-oncology neuroimaging. Elsevier Science Publishing Co Inc, 2016:85-8.
Benveniste RJ, Manzano G, Petito CK. Multifocal glioblastoma multiforme with synchronous spontaneous hemorrhage: Case report. J. Neurooncol. 2008;89:55-8.
Little JR, Dial B, Belanger G, Carpenter S. Brain hemorrhage from intracranial tumor. Stroke. 1979;10:283-8.
Byard RW. Parasagittal meningioma: A not so benign entity. Medicine, Science and the Law. 2017;96, 002580241773226.
Cancer Facts & Figures 2015. American Cancer Society. Available at http://www.cancer.org/acs/groups/con- tent/@editorial/documents/document/acspc-044552. pdf. Accessed: August 19, 2015.
Fink KR, Fink JR. Imaging of brain metastases. Surg. Neurol. Int. 2013;4 (Suppl 4): S209-19.
Giglio P, Gilbert MR. Neurologic complications of cancer and its treatment. Curr Oncol Rep. 2010.12(1):50-9.
Gitto L., Bolino G., Cina S. Sudden unexpected deaths due to intracranial meningioma: presentation of six fatal cases, review of the literature, and a discussion of the mechanisms of death. Journal of Forensic Sciences. 2017.
Li X, Wang K, Zhang A, Song Z et al. Glioblastoma mimicking a cerebral contusion: A case report. Oncol Lett. 2013;6:1499-501.
GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. International Agency for Research on Cancer. Available at http://globocan.iarc.fr/Pages/fact_sheets_population. aspx. Accessed: August 10, 2015.
Grant R. Overview: Brain tumour diagnosis and man-brain metastasis: A literature review / A.E. Sloan, C.J. Nock, D.B. Einstein // Cancer Control. – 2009. – Vol. 16. – P. 248-55.
Bosnjak R. Spontaneous intracranial meningioma bleeding: Clinicopathological features and outcome/ R. Bosnjak, C. Derham, M. Popovic, J. Ravnik // J. Neurosurg. – 2005. – Vol. 103. – P. 473-484.
Yoo H. Surgical outcomes of hemorrhagic metastatic brain tumors / H. Yoo, E. Jung, H.S. Gwak [et al.] // Cancer Res. Treat. – 2011. – Vol. 43. – P. 102-107.
agement/Royal College of Physicians guidelines. J. Neurol. Neurosurg. Psychiatry. 2004;75 Suppl. 2:ii18- 23.
Navi BB, Reichman JS, Berlin D et al. Intracerebral and subarachnoid hemorrhage in patients with cancer. Neurol. 2010;74:494-501.doi:10.1212/WNL.0b013e3 181cef837.
Syunsuke Seki, Tomoya Kamide, Akira Tamase, Ken- taro Mori, Kunio Yanagimoto, Motohiro Nomura. Intraparenchymal hemorrhage from dural metastasis of breast cancer mimicking meningioma. Neuroradiol. J. 2016;29:3:179-82.
Kreisl TN, Toothaker T, Karimi S, DeAngelis LM. Ischemic stroke in patients with primary brain tumors. Neurol. 2008;70:2314-20. doi:10.1212/01.wnl.000031 4648.82924.6f.
Kazim SF, Bhatti AU. Glioblastoma multiforme masquerading as intracerebral haemorrhage: A diagnostic dilemma. J. Pak. Med. Assoc. 2011;61:196-7.
Mandybur TI. Intracranial hemorrhage caused by metastatic tumors. Neurol. 1977;27 (7): 650-5.
Kim DG, Park CK, Paek SH et al. Meningiomas manifesting intracerebral haemorrhage: A possible mechanism of haemorrhage. Acta Neurochir. (Wien). 2000; 142:165-8.
Sloan AE, Nock CJ, Einstein DB. Diagnosis and treatment of melanoma brain metastasis: A literature review. Cancer Control. 2009;16:248-55.
Bosnjak R, Derham C, Popovic M, Ravnik J. Spontaneous intracranial meningioma bleeding: Clini- copathological features and outcome. J. Neurosurg. 2005;103:473-84
Yoo H, Jung E, Gwak HS et al. Surgical outcomes of hemorrhagic metastatic brain tumors. Cancer Res. Treat. 2011;43:102-7.
This work is licensed under a Creative Commons Attribution 4.0 International License.