U. Spetzger et al., HEMANGIOBLASTOMAS OF THE SPINAL-CORD AND THE BRAIN-STEM - DIAGNOSTIC AND THERAPEUTIC FEATURES, Neurosurgical review, 19(3), 1996, pp. 147-151
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.