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Surgical management of intramedullary hemangioblastomas

OBJECTIVES: to report an experience and to present a surgical technique to achieve total resection and cure. METHODS: nine consecutive cases of intramedullary haemangioblastomas, operated between 2000 and 2008 are presented. The functional scale proposed by McCormick was used to evaluate the patients' neurological status. RESULTS: age at presentation varied from 13 to 45 (average 27.1) years. Four (44.4%) patients were male and five (55.5%), female. Two patients had an associated von Hippel-Lindau disease, with others haemangioblastomas. According to the site of presentation, seven (77.7%) were localized at the cervical region (including two at the cervico-medullary junction), and two (22.2%) at the thoracic level. Total resection was achieved in all cases. Three patients had some functional worsening immediately after surgical procedure. After six months, there were no patients with functional worsening comparing with the pre-operative status and two patients had clinical improvement. CONCLUSIONS: adequate knowledge of anatomy and the correct use of microsurgical techniques allowed total resection of these tumors with minimal morbidity and maximum functional recovery.

Hemangioblastomas; Spinal cord neoplasms; Microsurgery; von Hippel-Lindau disease


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