Document Detail


Urgent reoperation for major regional complications after removal of intracranial tumors: outcome and prognostic factors in 100 consecutive cases.
MedLine Citation:
PMID:  17587775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Outcome of urgent reoperation for major regional complication after removal of intracranial tumor was evaluated retrospectively in 100 consecutive patients treated since 1983. Urgent reoperation was performed from 3 to 240 hours (mean 74 hours) after primary surgery for 32 meningiomas, 23 pituitary adenomas, 22 gliomas, 13 vestibular schwannomas, and 10 other intracranial neoplasms. Mean Glasgow Coma Scale (GCS) score before reoperation was 8. Brain edema was the most frequent operative finding at reoperation (31 patients), followed by extradural hematoma (25) and brain ischemia (24). Removal of various types of intracranial hematomas was the most common surgical procedure at reoperation (47 cases). Final outcome was considered favorable in 54 patients, who were discharged without major neurological deficit, and unfavorable in 46, with severe disability or vegetative state in four and death in 42. Multivariate analysis showed statistically significant association with the outcome for histological type of the tumor (p < 0.0001), clinical state at admission (p < 0.001), GCS score before urgent reoperation (p = 0.001), time interval between primary surgery and urgent reoperation (p < 0.01), and patient age (p < 0.05). Therefore, the outcome after urgent reoperation due to major regional complications after removal of intracranial tumor is determined mainly by the clinical condition of the patient and characteristics of the tumor, and less influenced by the type of complication.
Authors:
Mikhail F Chernov; Pavel I Ivanov
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurologia medico-chirurgica     Volume:  47     ISSN:  0470-8105     ISO Abbreviation:  Neurol. Med. Chir. (Tokyo)     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400775     Medline TA:  Neurol Med Chir (Tokyo)     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  243-8; discussion 248-9     Citation Subset:  IM    
Affiliation:
Department of Surgical Neurooncology, Russian A.L. Polenov Neurosurgical Institute, St. Petersburg, Russia. m_chernov@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Edema / etiology,  physiopathology,  surgery
Brain Ischemia / etiology,  physiopathology,  surgery
Brain Neoplasms / surgery*
Emergency Medical Services / statistics & numerical data*,  trends
Female
Hematoma, Epidural, Cranial / etiology,  physiopathology,  surgery
Humans
Male
Middle Aged
Monitoring, Physiologic / standards
Neurosurgical Procedures / adverse effects*,  mortality*
Postoperative Care / standards
Postoperative Complications / mortality*,  physiopathology
Prognosis
Reoperation / statistics & numerical data,  trends
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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