HEMANGIOBLASTOMAS OF THE SPINAL-CORD AND THE BRAIN-STEM - DIAGNOSTIC AND THERAPEUTIC FEATURES

Hemangioblastomas of the spinal cord and the brainstem make up 4% of a ll spinal tumors and are less common than cerebellar hemangioblastomas . CT and MRI are essential for preoperative diagnosis. Nevertheless, c erebral and spinal angiography are also mandatory, since they allow a detailed study of the vascular situation, which is decisive for exact planning of a surgical strategy. The purpose of this study was to eval uate the diagnostic and therapeutic factors which influence surgical m orbidity and postoperative outcome. Twelve patients harbouring spinal (8 cases) or medullary (4 cases) hemangioblastomas, all symptomatic wi th sensorimotor deficits corresponding to the level of the lesion were evaluated. All patients were treated in our depart ment between Decem ber 1989 and September 1994. Complete resection of the lesion was achi eved in each case. Postoperatively, none of the patients showed deteri oration. Nine patients had immediate postoperative improvement of neur ological signs and symptoms; in three patients the initial neurologica l deficits remained unchanged during the in-patient period. Late posto perative outcome demonstrated a clear improvement;in only one patient was there no change of the clinical signs, while in the other 11 patie nts a significant improvement of pre-existing neurological deficits wa s experienced. We conclude that microsurgical resection of spinal and medullary hemangioblastomas with low morbidity is feasible.