Gross total surgical removal of malignant glioma from the medulla oblongata: report of two adult cases with reference to surgical anatomy

详细信息    查看全文

• 作者：Kazuhiko Kyoshima ; Keiichi Sakai ; Tetsuya Goto ; Akihiko Tanabe ; Atsushi Sato ; Hisashi Nagashima ; Jun Nakayama
• 关键词：brainstem ; medulla oblongata ; malignant glioma ; surgical anatomy ; direct surgery ; surgery
• 刊名：Journal of Clinical Neuroscience
• 出版年：2004
• 出版时间：January 2004
• 年：2004
• 卷：11
• 期：1
• 页码：75-80
• 全文大小：528 K

文摘

Surgery was performed on the medulla oblongata of two adult patients with malignant glioma. Gross total resection of the tumors, located laterally or medially in the upper half of the medulla respectively, was achieved. The patient with the medially located tumor experienced significant postoperative neurological deterioration including sleep apnea. The other patient with the laterally located tumor showed symptomatic improvement without respiratory complications. The patient with an anaplastic astrocytoma survived approximately 4 years and the patient with a glioblastoma multiforme approximately 2 years. Although the upper half of the medulla is more critical than the lower half, a lateral approach to the upper half of the medulla appears to be relatively safer than a medial approach. Some cases of focal malignant gliomas in the medulla may be amenable to gross total resection in order to achieve improved outcome. Surgery can be undertaken when a tumor is unilateral and its margin appears relatively clear on magnetic resonance images.