Microsurgery treatment of midline deep brain lesions (clinical analysis of 25 cases)

Abstract

Objective: To explore experience and methods in the microsurgical treatment of midline deep brain lesions. Methods: The clinical data of patients with midline deep brain lesions were retrospectively analyzed. The clinical manifestation, imaging findings, lesion locations, surgical procedures, pathological diagnosis and follow-up results were summarized and analyzed. All the lesions were located deeply in the brain midline: corpus callosum (n=1), thalamus and basal ganglia (n=6), lateral ventricle (n=4), the third ventricle (n=2), pineal region (n=8), brainstem and fourth ventricle region (n=4). Results: Symptoms of 25 cases improved to varying degrees after operation and all the lesions got gross total removal without perioperative death. Followed by necessary adjuvant radiotherapy and/or chemotherapy, there were no recurrence during the follow-up period. Conclusions: Suitable surgical approaches should be individually chosen according to lesion location, the surrounding neural and vascular anatomy, blood supply, the patient's medical condition and the operator's experience. Localization of minor lesions can be assisted by neuronavigation system. In addition to try to determine the border of the lesion during operation, we emphasize the protection of the surrounding vital neural structures and deep veins. Finally, adjuvant radiotherapy and/or chemotherapy based on histology should be adopted to prevent recurrence.