Cirurgia estereotáctica para processos expansivos intracranianos: diagnóstico e tratamento

Meneses, Murilo S.; Russ, Heloísa H. A.; Coelho Neto, Maurício; Ramina, Ricardo; Hunhevicz, Sonival; Pedrozo, Ari; Tsubouchi, Mário H.

doi:10.1590/S0004-282X1996000100011

Resumos

Os autores apresentam série 50 pacientes submetidos a cirurgia estereotáctica para processos expansivos intracranianos. Em 12 casos realizou-se um procedimento terapêutico: ressecção tumoral guiada em 5 pacientes e aspiração do conteúdo da lesão nos outros 7. Neste estudo confirmam-se a grande precisão e a baixa morbidade relacionadas com as técnicas estereotácticas. A tomografia computadorizada e a ressonância magnética determinam com acurácia as coordenadas estereotácticas, mas em certos casos a estereo-angiografia cerebral deve ser realizada. As ressecções tumorais guiadas por estereotaxia permitem o tratamento de lesões cerebrais profundas ou em áreas funcionais anteriormente consideradas como inoperáveis. A literatura pertinente é discutida.

estereotaxia; tumores encefálicos; biópsia; microcirurgia

The authors present a study about 50 stereotactic procedures for intracranial lesions. In 12 cases stereotaxis was used as a treatment: stereotactic surgical resection (5 patients) and aspiration of lesions (7 patients). This study confirms the great accuracy and low morbidity of the stereotactic techniques. Computed tomography and magnetic resonance imaging determinate the precise stereotactic coordinates, but in some cases it is necessary to perform stereo-angiography. The stereotactic surgical resection of brain tumors allows the treatment of deep lesions or located at functional areas and considered to be inoperable before. The related literature is discussed.

stereotaxis; brain tumors; biopsy; microsurgery

Cirurgia estereotáctica para processos expansivos intracranianos: diagnóstico e tratamento

Stereotactic surgery for intracranial lesions: diagnosis and treatment

Murilo S. Meneses; Heloísa H. A. Russ; Maurício Coelho Neto; Ricardo Ramina; Sonival Hunhevicz; Ari Pedrozo; Mário H. Tsubouchi

RESUMO

Os autores apresentam série 50 pacientes submetidos a cirurgia estereotáctica para processos expansivos intracranianos. Em 12 casos realizou-se um procedimento terapêutico: ressecção tumoral guiada em 5 pacientes e aspiração do conteúdo da lesão nos outros 7. Neste estudo confirmam-se a grande precisão e a baixa morbidade relacionadas com as técnicas estereotácticas. A tomografia computadorizada e a ressonância magnética determinam com acurácia as coordenadas estereotácticas, mas em certos casos a estereo-angiografia cerebral deve ser realizada. As ressecções tumorais guiadas por estereotaxia permitem o tratamento de lesões cerebrais profundas ou em áreas funcionais anteriormente consideradas como inoperáveis. A literatura pertinente é discutida.

Palavras-chave: estereotaxia, tumores encefálicos, biópsia, microcirurgia.

ABSTRACT

The authors present a study about 50 stereotactic procedures for intracranial lesions. In 12 cases stereotaxis was used as a treatment: stereotactic surgical resection (5 patients) and aspiration of lesions (7 patients). This study confirms the great accuracy and low morbidity of the stereotactic techniques. Computed tomography and magnetic resonance imaging determinate the precise stereotactic coordinates, but in some cases it is necessary to perform stereo-angiography. The stereotactic surgical resection of brain tumors allows the treatment of deep lesions or located at functional areas and considered to be inoperable before. The related literature is discussed.

Key-words: stereotaxis, brain tumors, biopsy, microsurgery.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 5-setembro-1995.

Estudo realizado no Serviço de Neurocirurgia do Hospital das Nações, Curitiba.

Dr. Murilo Meneses - Avenida Getúlio Vargas 2159 - 80250-180 Curitiba PR - Brasil.

1. Abernathey CD, Camacho A, Kelly PJ. Stereotaxic suboccipital transcerebellar biopsy of pontine mass lesions. J Neurosurg 1989; 70:195-200.
2. Apuzzo MLJ, Chandrasoma PT, Cohen D, Zee CS, Zelman V. Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. Neurosurgery 1987; 20:930-937.
3. Blatt DR, Friedman WA, Agee OF. Delayed computed tomography contrast enhancement patterns in biopsy proven cases. Neurosurgery 1993; 32:560-569.
4. Brucher JM. Neuropathological diagnosis with stereotactic biopsies. Possibilities, difficulties and requirements. Acta Neurochir (Wien) 1993; 124:37-39.
5. Davis DH, Kelly PJ, Marsh R, Kall BA, Goerss SJ. Computer-assisted stereotactic biopsy of intracranial lesions. Appl Neurophysiol 1987; 50:172-177.
6. Devaux BC, O'Fallon J, Kelly PJ. Resection, biopsy, and survival in malignant glial neoplasms. J Neurosurg 1993; 78:767-775.
7. Gildenberg PL. The history of stereotactic neurosurgery. Neurosurg Clin N Am 1990; 1:765-780.
8. Kelly PJ. Volumetric stereotactic surgical resection of intra-axial brain mass lesions. Mayo Clin Proc 1988; 63:1186-1198.
9. Kelly PJ. Stereotactic biopsy and resection on thalamic astrocytomas. Neurosurgery 1989; 25:185-195.
10. Kelly PJ, Daumas-Duport C, Kispert DB, Kail BA, Scheithauer BW, Illig J. Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 1987; 66:865-874.
11. Kelly PJ, Hunt C. The limited value of cytoreductive surgery in elderly patients with malignant gliomas. Neurosurgery 1994; 34:62-67.
12. Kondziolka D, Dempsey PK, Lunsford LD, Kestle JRW, Dolan EJ, Kanal E, Tasker RR. A comparison between magnetic resonance imaging and computed tomography for stereotactic coordinate determination. Neurosurgery 1992; 30:402-407.
13. Lobato RD, Rivas JJ, Cabello A, Roger R. Stereotactic biopsy of brain lesions visualized with computed tomography. Appl Neurophysiol 1982; 45:426-430.
14. Mathisen JR, Giunta F, Marini G, Backlund EO. Transcerebellar biopsy in the posterior fossa: 12 years experience. Surg Neurol 1987; 28:100-104.
15. Meneses MS, Kelly PJ. Microcirurgia estereotáxica para remoção radical de cistos colóides do terceiro ventriculo. Arq Bras Neurocirurg 1992; 11:69-75.
16. Meneses MS, O'Neill B, Kelly PJ. Biópsia estereotáxica para linfomas primários do sistema nervoso central. Arq Neuropsiquiatr 1992; 50:319-323.
17. Musolino A, Cambria S, Rizzo G, Cambria M. Symptomatic cyst of the pineal gland: stereotactic diagnosis and treatment of two cases and review of the literature. Neurosurgery 1993; 32:315-321.
18. Neal JH, Van Norman AS. Transcerebellar biopsy of posterior fossa lesions using the Leksell gamma model stereotactic frame. Neurosurgery 1993; 32:473-475.
19. Ostertag CB, Mennel HD, Kiessling M. Stereotactic biopsy of brain tumors. Surg Neurol 1980; 14:275-283.
20. Sofat A, Kratimenos G, Thomas DGTT. Early experience with the Gill Thomas locator for computed tomography-directed stereotactic biopsy of intracranial lesions. Neurosurgery 1992; 31:972-974.
21. Spiegelmann R, Friedman WA. Stereotactic suboccipital transcerebellar biopsy under local anesthesia using the Cosman-Roberts-Wells frame. J Neurosurg 1991; 75:486-488.
22. Stern JD, Ross DA. Stereotactic management of benign pineal region cysts: report of two cases. Neurosurgery 1993; 32:310-314.
23. Thomas DGT, Nouby RM. Experience in 300 cases of CT-directed stereotactic surgery for lesion biopsy and aspiration of haematoma. Br J Neurosurg 1989; 3:321-326.
24. Wen DY, Hall WA, Miller DA, Seljeskog EL, Maxwell RE. Targeted brain biopsy: a comparison of freehand computed tomography-guided and stereotactic techniques. Neurosurgery 1993; 32:407-413.

Datas de Publicação

Publicação nesta coleção
07 Dez 2010
Data do Fascículo
Mar 1996

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Abernathey CD, Camacho A, Kelly PJ. Stereotaxic suboccipital transcerebellar biopsy of pontine mass lesions. J Neurosurg 1989; 70:195-200.

[2] 2. Apuzzo MLJ, Chandrasoma PT, Cohen D, Zee CS, Zelman V. Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. Neurosurgery 1987; 20:930-937.

[3] 3. Blatt DR, Friedman WA, Agee OF. Delayed computed tomography contrast enhancement patterns in biopsy proven cases. Neurosurgery 1993; 32:560-569.

[4] 4. Brucher JM. Neuropathological diagnosis with stereotactic biopsies. Possibilities, difficulties and requirements. Acta Neurochir (Wien) 1993; 124:37-39.

[5] 5. Davis DH, Kelly PJ, Marsh R, Kall BA, Goerss SJ. Computer-assisted stereotactic biopsy of intracranial lesions. Appl Neurophysiol 1987; 50:172-177.

[6] 6. Devaux BC, O'Fallon J, Kelly PJ. Resection, biopsy, and survival in malignant glial neoplasms. J Neurosurg 1993; 78:767-775.

[7] 7. Gildenberg PL. The history of stereotactic neurosurgery. Neurosurg Clin N Am 1990; 1:765-780.

[8] 8. Kelly PJ. Volumetric stereotactic surgical resection of intra-axial brain mass lesions. Mayo Clin Proc 1988; 63:1186-1198.

[9] 9. Kelly PJ. Stereotactic biopsy and resection on thalamic astrocytomas. Neurosurgery 1989; 25:185-195.

[10] 10. Kelly PJ, Daumas-Duport C, Kispert DB, Kail BA, Scheithauer BW, Illig J. Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 1987; 66:865-874.

[11] 11. Kelly PJ, Hunt C. The limited value of cytoreductive surgery in elderly patients with malignant gliomas. Neurosurgery 1994; 34:62-67.

[12] 12. Kondziolka D, Dempsey PK, Lunsford LD, Kestle JRW, Dolan EJ, Kanal E, Tasker RR. A comparison between magnetic resonance imaging and computed tomography for stereotactic coordinate determination. Neurosurgery 1992; 30:402-407.

[13] 13. Lobato RD, Rivas JJ, Cabello A, Roger R. Stereotactic biopsy of brain lesions visualized with computed tomography. Appl Neurophysiol 1982; 45:426-430.

[14] 14. Mathisen JR, Giunta F, Marini G, Backlund EO. Transcerebellar biopsy in the posterior fossa: 12 years experience. Surg Neurol 1987; 28:100-104.

[15] 15. Meneses MS, Kelly PJ. Microcirurgia estereotáxica para remoção radical de cistos colóides do terceiro ventriculo. Arq Bras Neurocirurg 1992; 11:69-75.

[16] 16. Meneses MS, O'Neill B, Kelly PJ. Biópsia estereotáxica para linfomas primários do sistema nervoso central. Arq Neuropsiquiatr 1992; 50:319-323.

[17] 17. Musolino A, Cambria S, Rizzo G, Cambria M. Symptomatic cyst of the pineal gland: stereotactic diagnosis and treatment of two cases and review of the literature. Neurosurgery 1993; 32:315-321.

[18] 18. Neal JH, Van Norman AS. Transcerebellar biopsy of posterior fossa lesions using the Leksell gamma model stereotactic frame. Neurosurgery 1993; 32:473-475.

[19] 19. Ostertag CB, Mennel HD, Kiessling M. Stereotactic biopsy of brain tumors. Surg Neurol 1980; 14:275-283.

[20] 20. Sofat A, Kratimenos G, Thomas DGTT. Early experience with the Gill Thomas locator for computed tomography-directed stereotactic biopsy of intracranial lesions. Neurosurgery 1992; 31:972-974.

[21] 21. Spiegelmann R, Friedman WA. Stereotactic suboccipital transcerebellar biopsy under local anesthesia using the Cosman-Roberts-Wells frame. J Neurosurg 1991; 75:486-488.

[22] 22. Stern JD, Ross DA. Stereotactic management of benign pineal region cysts: report of two cases. Neurosurgery 1993; 32:310-314.

[23] 23. Thomas DGT, Nouby RM. Experience in 300 cases of CT-directed stereotactic surgery for lesion biopsy and aspiration of haematoma. Br J Neurosurg 1989; 3:321-326.

[24] 24. Wen DY, Hall WA, Miller DA, Seljeskog EL, Maxwell RE. Targeted brain biopsy: a comparison of freehand computed tomography-guided and stereotactic techniques. Neurosurgery 1993; 32:407-413.