[Tumours of chiasmatic and hypothalamic regions in children (author's transl)].
Carlos F. Dabdoub, I Pascual Castroviejo, Francisco J. Villarejo, A Martínez Bermejo, Roche Mc
Abstract
Carlos F. Dabdoub, I Pascual Castroviejo, Francisco J. Villarejo, A Martínez Bermejo, Roche Mc
Abstract
31 cases with tumours in chiasm and hypothalamus are presented. 21 cases had glioma of chiasma (the tumor continued along one or both optic nerves), six cases had craniopharyngioma and four cases had astrocytoma in the hypothalamus. All of these tumours represent 19% of intracranial tumours observed in our service over a period of eleven years. Russell's syndrome was usually seen in cases of gliomas of chiasm. Visual alterations were observed in a high average of patients with any type of the tumours. Skull in lateral view was a positive proof in all the three types of tumours showing "omega" sella turcica in gliomas of chiasm, supra or retro-sellar calcifications in croniopharyngiomas and large sella turcica in astrocytomas of the hypophalamus. Neumoencephalography and angiography were very positives proofs in all types of tumours. Gammagraphy was specially possitive in gliomas of chiasm. Computed axial tomography is very useful in all types of tumour, but our experience is still limited in comparison with other methods. Most effective treatment for gliomas of the chiasm was radiotherapy with shunt in cases with hydrocephalus and total or partial extirpation in astrocytomas of the hypothalamus and in craniopharyngiomas. Survival rate among patients with these types of tumour is high but presence of visual and endocrinological secuelae is very high too.
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31 cases with tumours in chiasm and hypothalamus are presented. 21 cases had glioma of chiasma (the tumor continued along one or both optic nerves), six cases had craniopharyngioma and four cases had astrocytoma in the hypothalamus. All of these tumours represent 19% of intracranial tumours observed in our service over a period of eleven years. Russell's syndrome was usually seen in cases of gliomas of chiasm. Visual alterations were observed in a high average of patients with any type of the tumours. Skull in lateral view was a positive proof in all the three types of tumours showing "omega" sella turcica in gliomas of chiasm, supra or retro-sellar calcifications in croniopharyngiomas and large sella turcica in astrocytomas of the hypophalamus. Neumoencephalography and angiography were very positives proofs in all types of tumours. Gammagraphy was specially possitive in gliomas of chiasm. Computed axial tomography is very useful in all types of tumour, but our experience is still limited in comparison with other methods. Most effective treatment for gliomas of the chiasm was radiotherapy with shunt in cases with hydrocephalus and total or partial extirpation in astrocytomas of the hypothalamus and in craniopharyngiomas. Survival rate among patients with these types of tumour is high but presence of visual and endocrinological secuelae is very high too.
Key concepts: Optic chiasma, Sella turcica, Craniopharyngioma, Optic chiasm, Medicine, Astrocytoma, Tuberculum sellae, Glioma