The value of the ventriculo-atrial shunt used before the removal of a posterior fossa tumour determined by cerebrospinal fluid pressure recording.
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Biomedical subjects
Publications and source records attributed to Z Stocka-Muszyńska.
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Differential diagnosis in the material was based on the neurological and radiological findings made in 45 patients with third-ventricle tumours and 133 with subtentorial tumours. No clinical syndrome has been found which could help in reliable diagnosis concerning either of these locations of the tumour. Of decisive significance for the correct localization of tumours was ventriculography which established the diagnosis in 42 cases of third-ventricle tumours and 103 cases of subtentorial tumours. The most difficult problem was recognition of the relation of the subtentorial tumours to the brain stem since this relation could not be indicated unequivocally neither by clinical findings nor by radiological examination. This required surgical revision of the posterior fossa in most cases with suspected brain stem tumours.
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In 12 patients with hydrocephalus caused by posterior fossa tumours continuous measurements of intraventricular CSFP were done before and after implantation of ventriculoatrial valve and after tumour removal. A fall of the mean CSFP from 31.57 mm Hg to 15.32 mm Hg was observed after valve implantation, and a further fall of the mean CSFP to 10.55 mm Hg after removal of the tumour. After valve implantation pathological A and B waves disappeared. Absence of improvement after different stages of treatment indicated poor functioning of the valve, but it was observed also in patients with inoperable tumours.
The curves of cerebrospinal fluid pressure (CFP) in the lateral cerebral ventricle during the so called ventricular filling-up test are presented in 6 patients with high-pressure and medium-pressure hydrocephalus as compared with CFP curves obtained in 2 patients with low-pressure hydrocephalus. The method of filling-up test (infusion test) is described. In this method portions of normal saline 2 ml each are administered rapidly into a lateral ventricle every 30 seconds. The obtained results demonstrated a difference in the shape of the CFP curves in patients with low-pressure open hydrocephalus as compared with patients with closed hydrocephalus. This could help in qualifying patients with hydrocephalus for treatment with ventriculo-atrial shunt.
The purpose of the study was an attempt at evaluation of therapeutic results in 10 cases of tumours situated in the pineal region. The diagnosis was based on clinical and neuroradiological findings. Treatment included neurosurgical decompressing procedures (by the methods of Torkildsen, Pudenz Stookey-Scarf) followed in all cases by Co60 radiotherapy. The results of treatment expressed as survival rates were similar to those reported by others.