Результати лікування хворих із супратенторіальними пухлинами мозку з інсультоподібним перебігом у ранній післяопераційний період

Abstract

Objective – to study early results of surgical treatment in 176 patients with supratentorial tumors (ST) with a stroke-like course. Materials and methods. The results of surgical treatment of 176 patients with stroke-like tumors were studied. They were treated at the urgent neurosurgery clinic of the Kyiv Emergency Hospital during the period from 2008 to 2015. The age of the patients was 20-70 years, the average age was (53.7 ± 13.4) years. There were 104 (59.1 %) men, 72 (40.9 %) women. Intracerebral tumors were diagnosed in 156 (88.6 %) cases, metastasis was observed in 35 (19.9%), 20 (11.4 %) patients have extracranial tumors Patients were divided into two groups depending on cerebrovascular accident: the group I – 103 patients had hemorrhagic type of cerebrovascular accident, the group II – 73 patients had ischemic type of cerebrovascular accident. In early postoperative period, CT and/or MRI was performed in all cases to detect postoperative complications and evaluate the radicality of surgical resection. An ophthalmologic review before and after surgery was performed. Results. Total resection was achieved in 68 (38.6 %) patients, near total – in 82 (46.6 %), subtotal – in 26 (14.8 %). All 176 patients had less than 70 points of Karnovsky scale before surgery, after treatment the number of this patients decreased to 36 (20.5 %) patients. Improvement of quality life was noted in regression of neurological deficits, restoration of functional disorders, high degree of social adaptation. Conclusions. The main criteria of successful surgical treatment of tumors with stroke-like course. is the survival of patients with radical surgical resection and satisfactory quality of life in the postoperative period. Factors that influence the removal of the tumors with stroke-like course are size of the lesion, its localization, and the histological characteristics of the tumors. Therapeutic tactics in patients with tumors with stroke-like course should be based on an individual approach. Adequate surgical removal of the tumors and hematomas evacuation improve the quality of life in most patients (79.5 %).