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Culture Documents
Preoperative management
Preoperative management
Management of hydrocephalus
Shunting procedure prior tumor resection in
symptomatic cases and adequate tumor removal
can not be achieved
Preoperative steroid medication combined with
temporary cerebrospinal drainage
(ventriculostomy) just before removing out the
tumor
Perioperative management
IV line insertion
ECG
Antibiotic administration
Catheter insertion
Steroid medication
Manitol, furosemid
Lumbar drain insertion
Monitoring
Operative management
Operative management
Surgical approaches
Bifrontal
Middle frontal
Frontotemporal (pterional)
Frontotemporal (extended temporal
Temporal
Occipital
Posterior frontoparietal
Temporal occipital
Suboccipital
Operative management
Tumor removal
First priority: preserve or improve neurologic
function
Benign tumor: total removal (if possible)
Malignant tumor: reduce tumor burden
Brain tumors
Benign
Malignant
General classification
Neuroepithelial tumors
Gliomas
Neuronal tumors
Meningioma
Meduloblastoma
Meningeal tumors
Neurinoma
Metastatic tumors
Classification of astrocytomas
Kernohan
Grade
WHO designation
I
II
III
IV
Epidemiology
Location: Temporal, posterior frontal, anterior
parietal lobe
Mostly affects children and young adult
Consists of 15% of all primary CNS tumors
Imaging
Management
Observation
Surgical resection
Prognosis
Anaplastic astrocytoma
Glioblastoma multiforme
Malignant astrocytomas
Epidemiology
Malignant astrocytomas
Imaging
Management
Surgical resection
Radiation treatment
Chemotherapy
Prognosis
Life expectancy:
Pylocytic astrocytoma
Key features:
Oligodendroglioma
Epidemiology
4% of all glioma
Affect adult age (male : female = 3:2)
Mostly located in cerebral hemisphere
Clinical features
Slow growing
Epilepsy 80% of cases (for many years prior
to the diagnosis)
Oligodendroglioma
Imaging
CT scan of oligodendroglioma
Oligodendroglioma
Management
Surgical resection
Radiotherapy
Chemotherapy
Prognosis
Meningiomas
Epidemiology
Meningiomas
Imaging
CT scan of menigiomas
CT scan of meningiomas
Meningiomas
Management
Surgical resection
Prognosis
Commonly good
Neurinoma
Epidemiology
Involves sensory and motor cranial nerve (VIII,
V, VII)
10% of all intracranial tumors
4th and 5th decade of life
Predominantly affects women
Neurinoma
Imaging
Neurinoma
Management
Prognosis
Meduloblastoma
Epidemiology
CT scan of Meduloblastoma
CT scan of meduloblastoma
Meduloblastoma
Management
Surgical resection
Radiation therapy
Chemotherapy
Meduloblastoma
Prognosis
Metastatic tumors
Epidemiology
Metastatic tumors
Location of metastases
Metastatic tumors
Imaging
Around well circumscribed mass in the junction
of white and gray matter with severe finger like
pattern brain edema
Some with multiple lesions
Metastatic tumors
Management
Surgical resection
Stereotactic biopsy
Whole brain radiotherapy (WBRT)
Chemotherapy
Metastatic tumors
Prognosis
Summary