Treatment of brain and spinal cord tumors
Oncology / / May 14, 2016
Currently, the most effective treatment for brain and spinal cord tumors is surgical removal.
In malignant forms of radical removal of the brain and spinal cord tumors in combination with chemotherapy, radiotherapy and immunotherapy give a more encouraging results.
Each brain tumor, regardless of its nature without surgery eventually becomes lethal for the patient.Contraindicated operation only when the general grave condition of the patient, accompanied by serious violations of the vital functions of the body.On the question of the timing of the operation should adhere to the provisions of the benefits of early surgery.Operations performed for brain tumors, are both common and distinctive features.The latter depends on the tumor, especially its vascularisation and sizes.Common methods are opening, skull, manipulation of the soft tissues of the head and in the meninges.
To remove supratentorial tumors (ie. E. Supratentorial) resorted primarily to osteoplastic craniotomy with the formation of a separa
Meningiomas - the most representative shell-vascular tumors - thanks extracerebral growth largely amenable to complete resection followed by a favorable outcome.The difficulties attendant removal of these tumors, usually due to the large size of tumors and their abundant vascularization.
Brain Meningioma convex surface can be removed completely by gradually separating it from the first or the brain, in order to reduce its size, vnutrikapsulyarno partially and then completely with the capsule.In the event of damage to the wall of a large longitudinal sinus it has to take in.If the tumor grows longitudinal sinus and the crescent process, extending in the direction of one or both hemispheres, it is advisable to resect with her crescent process and sinus in the part where he was obliterated by the tumor.
Meningiomas base of the brain, developing in the Turkish saddle tubercle, olfactory fossa, and the wings of the sphenoid bone, can not always be removed in its entirety.Sometimes they are soldered to the trunk blood vessels and nerves of the brain base.In such cases, the tumor first removed kuskovaniem nntrakapsulyarno.Part of it is intimately associated with the vessels or the optic nerve can be left unremoved to avoid damaging them.
Tumors of the pituitary gland is removed as the intracranial and extracranial methods.In the first case after craniotomy osteoplastic surgeon approaches the tumor at the base of the frontal lobe.In the second case it made submucosal approach to the tumor through the nasal cavity and the main sinus, which after opening the bottom of the sella trepanning.In both cases, the tumor is removed within the confines sella turcica and diaphragm.
Postoperative radiation therapy in a large percentage of cases prevents recurrence of tumor growth.Results of surgical treatment of gliomas are unfavorable.This is due to their infiltrative growth and tendency to malignancy.Favorable results are observed after removal of astrocytomas and oligodendrogliomas, located in the white matter of the brain hemispheres, least favorable - with glioblastoma multiforme, extending to the basal ganglia and corpus callosum.The depth of the gliomas forced to resort to the surgeon's dissection of cortex and white matter of the brain.Implement it should only be functionally less significant cortical areas to the tumor removal does not entail a violation of speech, movement or other functions.Removal of the tumor or to be part of it, located in the white matter of the hemisphere and growing into the lateral cavity of the stomach.The desire to remove the tumor or part of it affecting basal ganglia, corpus callosum, and the transparent barrier is not justified due to adverse results.
extracerebral tumors of the posterior cranial fossa, localized mainly in the cerebellopontine angle (acoustic neuroma, meningioma, etc..), Amenable to complete resection.At the same time should be avoided and damage to the brain stem extending from his roots of cranial nerves.
When glial tumors of the cerebellum have to dissect the worm or substance cerebellar hemisphere.It is necessary to consider the possibility of sprouting tumor of the roof of the IV ventricle and ventricular cavity opening at its disposal.We must strive to complete excision of the tumor, but the removal of the tumor can not be soldered to the bottom of the IV ventricle.Then by partial removal of the tumor, it is desirable to restore the natural likvoroottok of the aqueduct of Sylvius.In medulloblastoma subsequent radiation therapy has a beneficial effect.
On removal of metastatic brain tumors is expedient to raise the question, if the metastatic focus is single.In cases where the radical or partial removal of the tumor is not possible, resort to palliative operations - dekompressivioy trepanation, the establishment of a permanent drainage of the ventricular system.