Microsurgical Resection of Spinal Cord Hemangioblastomas

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-372-ONS-376 ◽  
Author(s):  
Russell R. Lonser ◽  
Edward H. Oldfield
Keyword(s):  
Spinal Cord ◽  
Blood Loss ◽  
Benign Tumors ◽  
Intramedullary Spinal Cord ◽  
Von Hippel Lindau ◽  
Spinal Cord Neoplasms ◽  
Von Hippel Lindau Disease ◽  
Microsurgical Resection

Abstract HEMANGIOBLASTOMAS ARE NOT uncommon intramedullary spinal cord neoplasms. They are highly vascular, benign tumors that occur either sporadically or in the presence of von Hippel-Lindau disease. Despite their exceptionally vascular nature, these lesions can consistently be resected completely and safely with minimal blood loss. We describe a microsurgical method for removal of these tumors from the spinal cord.

Microsurgical resection of intramedullary spinal cord ependymoma

2014 ◽  
Vol 37 (v2supplement) ◽  
pp. Video9
Author(s):  
Paul C. McCormick
Keyword(s):  
Spinal Cord ◽  
Growth Rate ◽  
Spinal Cord Tumor ◽  
Intramedullary Spinal Cord ◽  
Clear Margin ◽  
Intramedullary Spinal Cord Tumor ◽  
Link Type ◽  
Microsurgical Resection ◽  
Spinal Cord Ependymoma ◽  
Posterior Midline

Ependymomas are the most commonly occurring intramedullary spinal cord tumor in adults. With few exceptions these tumors are histologically benign, although they exhibit some biologic variability with respect to growth rate. While unencapsulated, spinal ependymomas are non-infiltrative and present a clear margin of demarcation from the surrounding spinal cord that serves as an effective dissection plane. This video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy.The video can be found here: http://youtu.be/lcHhymSvSqU.

Hemangioblastoma diagnosis and surveillance in von Hippel–Lindau disease: a consensus statement

2021 ◽  
pp. 1-6
Author(s):  
Kristin Huntoon ◽  
Matthew J. Shepard ◽  
Rimas V. Lukas ◽  
Ian E. McCutcheon ◽  
Anthony B. Daniels ◽  
...  
Keyword(s):  
Age At Onset ◽  
Benign Tumors ◽  
Expert Committee ◽  
Level Of Evidence ◽  
Von Hippel Lindau ◽  
Assessment Development ◽  
History Of ◽  
Von Hippel Lindau Disease ◽  
The Central Nervous System ◽  
Cancer Network

OBJECTIVE Hemangioblastomas are a frequent underlying cause of neurological morbidity and death in patients with von Hippel–Lindau disease (VHL). Although these benign tumors can cause significant neurological debility when undetected and untreated, unified evidence-based surveillance recommendations for VHL patients have not been established. To develop consensus recommendations, the VHL Alliance established an expert committee, named the International VHL Surveillance Guidelines Consortium, to define surveillance recommendations. METHODS The Central Nervous System (CNS) Hemangioblastoma Subcommittee of the Guidelines Consortium was formed as a multidisciplinary team of experts in the diagnosis and management of hemangioblastomas. Recommendations were formulated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and National Comprehensive Cancer Network Categories of Evidence and Consensus categorization after a comprehensive literature review. RESULTS Published studies (n = 49) that discussed age at onset, MRI frequency, natural history of VHL, and the risks and benefits of surveillance were analyzed. Based on this analysis, the authors recommend that clinical evaluation (yearly) be used as the primary screening tool for hemangioblastomas in VHL. The subcommittee suggests that screening be performed between the ages of 11 and 65 years, or with the onset of symptoms, for synchronicity with other testing regimens in VHL. The subcommittee also recommends that baseline MRI be first performed at the age of 11 years (suggested 2B, level of evidence D) or after identification of neurological symptoms or signs (if earlier) and continue every 2 years (recommended 2A, level of evidence A). CONCLUSIONS The CNS Hemangioblastoma Subcommittee of the International VHL Surveillance Guidelines Consortium here proposes guidelines that aim to increase the early detection of VHL-associated hemangioblastomas to reduce their morbidity and mortality.

scholarly journals Surgical treatment of primary intramedullary spinal cord tumors in adult patients

2008 ◽  
Vol 66 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Mario Augusto Taricco ◽  
Vinicius Monteiro de Paula Guirado ◽  
Ricardo Bragança de Vasconcellos Fontes ◽  
José Pindaro Pereira Plese
Keyword(s):  
Spinal Cord ◽  
Previous Treatment ◽  
Cervical Cord ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Treatment Protocols ◽  
Intramedullary Spinal Cord ◽  
Neurological Outcomes ◽  
Neurological Morbidity ◽  
Microsurgical Resection

BACKGROUND: Primary spinal cord intramedullary tumors are rare and present with insidious symptoms. Previous treatment protocols emphasized biopsy and radiation/chemotherapy but more aggressive protocols have emerged. OBJECTIVE: To report our experience. METHOD: Forty-eight patients were diagnosed with primary intramedullary tumors. The cervical cord was involved in 27% and thoracic in 42% of patients. Complete microsurgical removal was attempted whenever possible without added neurological morbidity. RESULTS: Complete resection was obtained in 33 (71%) patients. Neurological function remained stable or improved in 32 patients (66.7%). Ependymoma was the most frequent tumor (66.7%). CONCLUSION: Neurological outcome is superior in patients with subtle findings; aggressive microsurgical resection should be pursued with acceptable neurological outcomes.

Monotherapy with thalidomide for treatment of spinal cord hemangioblastomas in a patient with von Hippel-Lindau disease

2009 ◽  
Vol 53 (3) ◽  
pp. 464-467 ◽  
Author(s):  
Iacopo Sardi ◽  
Massimiliano Sanzo ◽  
Flavio Giordano ◽  
Anna Maria Buccoliero ◽  
Federico Mussa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Von Hippel Lindau ◽  
Von Hippel Lindau Disease

Microsurgical Resection of an Intramedullary Spinal Cord Hemangioblastoma Through an Anterior Cervical Approach: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Kyle Lindsey McCormick ◽  
Nikita Alexiades ◽  
Paul C McCormick
Keyword(s):  
Spinal Cord ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Complete Recovery ◽  
Surgical Removal ◽  
Intramedullary Spinal Cord ◽  
Dural Closure ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Microsurgical Resection

Abstract This video demonstrates the microsurgical removal of an intramedullary spinal cord hemangioblastoma through an anterior cervical approach. While most spinal hemangioblastomas arise from the dorsal or dorsolateral pial surface and can be safely resected through a posterior approach,1,2 ventral tumors can present a significant challenge to safe surgical removal.3-5 This patient presented with a progressively symptomatic ventral pial based hemangioblastoma at the C5-6 level with large polar cysts extending from C3 to T1. The tumor was approached through a standard anterior cervical exposure with a C5 and C6 corpectomy. Following midline durotomy, the tumor was identified and complete microsurgical resection was achieved. The principles and techniques of tumor resection are illustrated and described in the video. Following tumor resection and dural closure, a fibular allograft was inserted into the corpectomy defect and a C4-C7 fixation plate was placed. The patient was maintained in a supine position for 36 h. He was discharged home on postoperative day 3 in a cervical collar. The patient did well with near-complete recovery of neurological function. Postoperative magnetic resonance imaging at 6 wk showed a substantial resolution of the polar cysts and no evidence of residual tumor. The patient featured in this video consented to the procedure.

scholarly journals Resection of spinal hemangioblastoma

2014 ◽  
Vol 37 (v2supplement) ◽  
pp. Video15
Author(s):  
Giuseppe Lanzino ◽  
Saul F. Morales-Valero ◽  
William E. Krauss
Keyword(s):  
Spinal Cord ◽  
Venous Drainage ◽  
Complete Resection ◽  
Cervical Cord ◽  
Von Hippel Lindau ◽  
Link Type ◽  
Single Piece ◽  
Von Hippel Lindau Disease ◽  
Spinal Hemangioblastoma

Spinal cord hemangioblastomas occur as sporadic lesions or in the setting of Von Hippel-Lindau disease. In this intraoperative video we present a case of sporadic cervical cord hemangioblastoma and illustrate the main surgical steps to achieve safe and complete resection which include: identification and division of the feeding arteries; careful circumferential dissection of the tumor from the surrounding gliotic cord; identification, isolation and division of the main venous drainage and single piece removal of the tumor.The video can be found here: http://youtu.be/I7DxqRrfTxc.

Familial CNS Tumor Syndromes: Von Hippel-Lindau Disease

2017 ◽  
Author(s):  
Gurvinder Kaur ◽  
Leonel Ampie ◽  
Joseph Weiner ◽  
Aruna Ganju
Keyword(s):  
Clinical Picture ◽  
Genetic Disorder ◽  
Spontaneous Mutation ◽  
Benign Tumors ◽  
Cns Tumor ◽  
Von Hippel Lindau ◽  
Von Hippel Lindau Disease

Von Hippel-Lindau disease can be inherited or may be caused by a spontaneous mutation. Individuals diagnosed with this disease are prone to developing multiple benign tumors termed hemangioblastomas. This chapter addresses the epidemiology, clinical picture, and treatment of these tumors; specifically within those patients with this genetic disorder.

scholarly journals Spinal Cord Hemangioblastomas in von Hippel-Lindau Disease: Management of Asymptomatic and Symptomatic Tumors

2012 ◽  
Vol 53 (6) ◽  
pp. 1073 ◽  
Author(s):  
Tae Yup Kim ◽  
Do Heum Yoon ◽  
Hyun Chul Shin ◽  
Keung Nyun Kim ◽  
Seong Yi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Disease Management ◽  
Von Hippel Lindau ◽  
Von Hippel Lindau Disease
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