Summary
During a period of 17 years (from 1976 till now) 45 patients with giant gliomas of the chiasma and the IIIrd ventricle out of a total amount of 120 patients with hypothalamic gliomas were operated. The following classification of tumours was used: I) tumours with predominant anterior growth; II) tumours which infiltrate chiasma and penetrate into the IIIrd ventricle; III) gliomas of the floor of the IIIrd ventricle and the chiasma, growing into the ventricle cavity; IV) tumours of the chiasma, optic tract and thalamus. The authors come to the conclusion, that surgical removal of giant tumours of the chiasma and the IIIrd ventricle, though risky, may result in an improvement or stabilisation of visual functions (77%) and a long period free from recurrencies (9.5%). The postoperative period is relatively favourable and the mortality is low (6%). The main contraindication in our opinion is a wide infiltration of adjacent brain structures by the tumour and spreading along both optical tracts. We consider the giant size of a tumour in itself a sufficient indication for surgery.
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Raimondi AJ (1987) Pediatric neurosurgery. Springer, Berlin Heidelberg New York Tokyo, pp 274
Gillett GR, Symon L (1987) Hypothalamic glioma. Surg Neurol 28: 291–300
Apuzzo ML, Levy ML, Tung H (1991) Surgical strategies and technical methodologies in optimal management of craniopharyngioma and masses affecting the third ventricular chamber. Acta Neurochir (Wien) [Suppl] 53: 77–88
Koos WT, Perraczky A, Horaczek A (1985) Problems of surgical technique for the treatment of supratentorial midline tumours in children. Acta Neurochir (Wien) [Suppl] 35: 31–41
Gower DJ, Pollay M, Shuman RM, Brumback RA (1990) Cystic optic glioma. Neurosurgery 26: 133–136
Carmell PW (1985) Tumours of the III ventricle. Acta Neurochir (Wien) 75: 136–146
Stein BM (1980) Third ventricle tumours. Clinical neurosurgery, Vol. 27, pp 315–331
Albright AL, Sclabassi RJ (1985) Cavitron ultrasonic surgical aspiration and visual evoked potential monitoring for chiasmal gliomas in children. J Neurosurg 63: 138–140
Schuster H, Koos WT, Zaunbauer F (1977) Results of microsurgical treatment of gliomas of the optic system and hypothalamus in children. Mod Probl Pediatr 18: 211–215
Kretschmar CS, Linggood RM (1991) Chemotherapeutic treatment of extensive optic pathway tumors in infants. J Neurooncol 10: 263–270
Petronio J, Edwards MS, Prados M, Freyberger S, Rabbitt J, Silver P, Levin VA (1991) Management of chiasmal and hypothalamic gliomas of infancy and childhood with chemotherapy. J Neurosurg 74: 701–708
Packer RJ, Sutton LN, Bilaniuk LTet al (1988) Treatment of chiasmatic/hypothalamic gliomas of childhood with chemotherapy. Ann Neurol 23: 79–85
Bataini JP, Delanian S, Ponvert D (1991) Chiasmal gliomas: results of irradiation management in 57 patients and review of literature. Int J Radiat Oncol Biol Phys 21: 615–623
Capo H, Kupersmith MJ (1991) Efficacy and complications of radiotherapy of anterior visual pathway tumours. Neurol Clin 9: 179–203
Gould RJ, Hilal SK, Chutorian AM (1987) Efficacy of radiotherapy in Optic Gliomas. Pediatr Neurol 3: 29–32
McLaurin RL, Breneman J, Aron B (1987) Hypothalamic gliomas: review of 18 cases. Concepts in Pediatric Neurosurgery Vol 7. Karger, Basel, pp 19–29
Wechsler-Jentzsch K, Witt Jh, Fitz CR, McCullough DC, Harisiadis L (1988) Unresectable gliomas in children. Tumour-volume response to radiation therapy. Radiology 169: 237–242
Scott E, Mickle JP (1987) Pediatric diencephalic gliomas — a review of 18 cases. Pediatr Neurosci 13: 225–232
Lapras C: Personal communication
Konovalov AN, Gorelyshev SK (1992) Surgical treatment of anterior third ventricle tumours. Acta Neurochir (Wien) 118: 33–39
Konovalov AN, Bokeriya ZO (1986) Principles of diagnosis and surgical treatment of giant gliomas of the chiasma and optic nerves in children. Z Vopr Neurochir (Moscow) 6: 3–12
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Konovalov, A., Gorelyshev, S. & Serova, N. Surgery of giant gliomas of chiasma and IIIrd ventricle. Acta neurochir 130, 71–79 (1994). https://doi.org/10.1007/BF01405505
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DOI: https://doi.org/10.1007/BF01405505