78 research outputs found
Surgical treatment and predictive factors for atypical meningiomas: a multicentric experience
No full textBackground: Atypical meningiomas are characterized by a high rate of recurrence and shorter overall survival (OS) compared with grade I meningioma. Predictive parameters for OS and recurrence-free survival (RFS) are controversial. Methods: Patient age, sex, preoperative symptoms, tumor localization, size, Simpson grade, postoperative complications, extent of resection, number of mitoses, MIB1 proliferation index, brain invasion, postoperative radiotherapy, and clinical outcome (Karnofsky performance scale [KPS] postoperatively and at long-term follow-up) were evaluated. Data regarding recurrence rate, mortality, OS, and RFS at 1-, 3-, and 5-year follow-up were also collected. Median follow-up was 76 months; all patients had at least 3 years of follow-up. Results: Between 2007 and 2017, 73 patients underwent surgery for atypical meningiomas (World Health Organization grade II) at 2 centers. Preoperative KPS score >80 as well as 1-month, 6-month, and 1-year follow-up KPS scores were related to better OS. Postoperative complications did not modify OS and RFS. Gross total removal (Simpson grade I, II) was achieved in 80.8% of patients. RFS was statistically influenced by extent of resection (P = 0.002). MIB1 proliferation index >8 was a negative predictive factor for recurrence at univariate and multivariate analysis (P = 0.001 and P = 0.021). Radiotherapy was statistically related to a worse outcome. The incidence of recurrence was 38%. RFS was 98.6% at 1-year follow-up, 81.1% at 3 years, and 57.5% at 5 years. All patients were alive at 1-year follow-up. OS was 90.5% at 3-year follow-up and 78.8% at 5-year follow-up. Conclusions: Despite some limitations, our study demonstrates that aggressive surgical treatment achieving a gross total removal is a positive predictive parameter for RFS as well as a good clinical outcome (KPS score >80) and is related to a longer OS
Minimally invasive surgery of the anterior circulation cerebral aneurysms
Get PDFCilj: Usporediti skupine ispitanika liječenih jednim od dvaju kirurških postupaka u liječenju aneurizmi prednje cerebralne cirkulacije, pterionalnim pristupom ili supraorbitalnim keyhole pristupom, na temelju istraživanih pokazatelja i, na temelju te usporedbe, donijeti zaključke o mogućoj povezanosti istraživanih pokazatelja i potencijalnim prednostima i nedostatcima jednog u odnosu na drugi proučavani kirurški postupak.
Nacrt studije: Povijesna kohortna studija.
Ispitanici i metode: U istraživanje je uključeno 116 ispitanika s radiološki potvrđenom aneurizmom prednje cerebralne cirkulacije koji su liječeni jednim od dvaju navedenih kirurških pristupa u razdoblju od 2006. do 2015. godine. Svi podatci o istraživanim pokazateljima ispitanika (dob, spol, GCS, WFNS, HH, FISHER, lokalizacija aneurizme, popratne bolesti u anamnezi, prisutnost rupture i vrijeme proteklo od rupture do prijema, vrijeme operacije, komplikacije operacije i poslijeoperacijskog liječenja, GOS) preuzeti su iz medicinskih zapisa i statistički su obrađeni.
Rezultati: Značajna razlika između ispitivanih skupina utvrđena je u raspodjeli ispitanika koji su imali aneurizmu ACoA (χ2 test, p = 0,039). Značajna razlika utvrđena je u raspodjeli ispitanika s obzirom na GOS i HH nakon što su podijeljeni u dvije skupine, ovisno o rasponu vrijednosti HH (χ2 test, p = 0,021). U raspodjeli ispitanika s obzirom na ostale istraživane pokazatelje između ispitivanih skupina nije utvrđena značajna razlika.
Zaključak: Pterionalni pristup i supraorbitalni keyhole pristup ravnopravne su metode u kirurškom liječenju aneurizmi prednje cerebralne cirkulacije te se odluka o odabiru pristupu koji će se primijeniti treba temeljiti na individualnoj procjeni i preferenciji operatera. Krajnji ishod liječenja ne ovisi o primijenjenom kirurškom pristupu nego o kliničkom stanju pacijenta pri prijemu.Objectives: To compare two groups of participants treated by one of two surgical procedures of anterior cerebral circulation aneurysm treatment, pterional approach or supraorbital keyhole approach, according to considered parameters and, based on that comparison, bring conclusions on whether any of the parameters are related to other and on possible advantages and disadvantages of one approach compared to the other.
Study design: Retrospective cohort study.
Participants and methods: The study included 116 participants that had an anterior circulation cerebral aneurysm identified by radiological examination and were submitted to one of the two mentioned surgical approaches between 2006 and 2015 at the Clinic of Neurosurgery at Clinical Hospital Center Osijek. All data regarding the considered parameters (age, gender, GCS score, WFNS score, Hunt and Hess score, Fisher score, aneurysm localization, concomitant diseases, presence of rupture and elapsed time between the rupture and hospital reception, surgery timing, procedural or postoperative care complications, GOS score) were obtained from participants' medical records and statistically analyzed.
Results: Significant difference between the defined groups was found in aneurysm localization distribution regarding the participants with anterior communicating artery (ACOM) aneurysm (χ2 test, p = 0,039). Furthermore, significant difference in the distribution of GOS score and Hunt and Hess score was found when the participants who were divided into two groups, according to the range which their Hunt and Hess score could fit into (χ2 test, p = 0,021). Statistically significant difference between the defined groups in the distribution of any other considered parameter was not found.
Conclusion: Pterional approach and supraorbital keyhole approach are equally successful in treating anterior circulation cerebral aneurysms and the decision on which approach should be applied, should be made based on the individual assessment and surgeon's preferences. The final outcome of the treatment does not depend on the applied surgical approach but it depends on patient's Hunt and Hess score at the reception
Quality of life assessment after surgical treatment of brain glioma
No full textCILJ: Ispitati postoji li utjecaj dobi, patohistološkog stupnja malignosti, opsega kirurške resekcije, prije operacijskog kliničkog stanja, adjuvantnog liječenja te komorbiditeta i navika (arterijska hipertenzija, povećana tjelesna masa i pušenje) na kvalitetu života nakon kirurškog liječenja glioma mozga. NACRT ISTRAŽIVANJA: Istraživanje je ustrojeno kao presječna studija. ISPITANICI I POSTUPCI: U istraživanje su uključeni bolesnici s dijagnosticiranim gliomom mozga u razdoblju od 2016. do 2020. koji su liječeni na Klinici za neurokirurgiju i Zavodu za onkologiju Kliničkog bolničkog centra Osijek. Podaci o ispitanicima preuzeti su iz medicinske dokumentacije pohranjene na Kliničkom zavodu za patologiju i Zavodu za onkologiju Kliničkog bolničkog centra Osijek. Kao instrument istraživanja koristili su se upitnici Europske organizacije za liječenje raka: EORTC QLQ-C30, temeljni upitnik kojim se procjenjuje kvaliteta života kod bolesnika s malignim tumorom, te EORTC QLQ-BN20, dodatni upitnik kojim se ispituje problematika specifična za tumor mozga. REZULTATI: Među ispitanicima najbolje je ocjenjeno kognitivno, a najlošije socijalno i poslovno funkcioniranje. Najučestaliji simptomi bili su slabost nogu, motorička disfunkcija, umor i pospanost, gubitak apetita te teškoće u komunikaciji. Kvaliteta života statistički je značajno bila povezana sa spolom, stupnjem malignosti, prije operacijskim kliničkim stanjem, adjuvantnim liječenjem te komorbiditetima, točnije arterijskom hipertenzijom i povećanom tjelesnom masom. Nije bilo značajne povezanosti dobi i opsega kirurške resekcije s kvalitetom života nakon kirurškog liječenja glioma mozga. ZAKLJUČAK: Različiti čimbenici utječu na kvalitetu života nakon kirurškog liječenja glioma mozga. Bolesnici s gliomom višeg stupnja malignosti, vrijednostima KPS nižima ili jednakima 70, te oni s prisutnim komorbiditetima (arterijska hipertenzija i povećana tjelena masa) imaju značajno lošiju kvalitetu života. Dob i opseg kirurške resekcije čimbenici su koji ne utječu na kvalitetu života. Ključne riječi: gliom; komorbiditeti; kvaliteta života;OBJECTIVES: To examine whether there is an impact of age, pathohistological degree of malignancy, extent of surgical resection, preoperative clinical condition, adjuvant treatment, comorbidities and habits (arterial hypertension, weight gain, and smoking) onto the quality of life after surgical treatment of brain glioma. STUDY DESIGN: The research was organized as a cross-sectional study. PARTICIPANTS AND METHODS: The study included patients diagnosed with brain glioma in the period from 2016 to 2020 who were treated at the Clinics of Neurosurgery and the Department of Oncology of the Clinical Hospital Center Osijek. The patients' data were taken from the medical documentation stored at the Clinical Department of Pathology and the Department of Oncology of the University Hospital Center Osijek. Two questionnaires of the European Organization for Cancer Treatment were used as a research instrument: EORTC QLQ-C30, a basic questionnaire assessing the quality of life in patients with malignant tumors, and the EORTC QLQ-BN20, an additional questionnaire examining problems specific to the brain tumor. RESULTS: Among the examinees, cognitive functioning was evaluated as the best, and social and role functioning as the worst. The most common symptoms were leg weakness, motor dysfunction, fatigue and drowsiness, loss of appetite and difficulty communicating. Statistically, the quality of life was significantly associated with gender, degree of malignancy, pre-operative clinical condition, adjuvant treatment and comorbidities, more specifically arterial hypertension and weight gain. There was no significant correlation between the age and extent of surgical resection with the quality of life after surgical treatment of brain glioma. CONCLUSION: Various factors affect the quality of life after surgical treatment of brain glioma. Patients with a higher grade glioma, KPS values lower than or equal to 70, and those with comorbidities (arterial hypertension and increased body weight) have a significantly worse quality of life. The age and extent of surgical resection are factors that do not affect the quality of life
Characteristics of the skull base meningothelial tumors
Get PDFCilj istraživanja: Ispitati postoji li povezanost između bolesnikove dobi i spola, kao i stanja
svijesti, lokalizacije tumora, opsežnosti kirurškog uklanjanja, patohistološkog stupnja tumora,
poslijeoperacijskih komplikacija i konačnog ishoda liječenja meningeoma lubanjske osnovice.
Nacrt studije: Presječna studija.
Ispitanici i metode: U istraživanje su uključeni svi bolesnici s dijagnosticiranim
meningeomom lubanjske osnovice koji su liječeni u Klinici za neurokirurgiju KBC-a Osijek u
razdoblju od 2000. do 2015. godine. Podatci ispitanika preuzeti su iz medicinske
dokumentacije pohranjene u arhivu Klinike za neurokirurgiju KBC-a Osijek. Konačni ishod
liječenja određen je Karnofskyjevim indeksom (KPI) pri otpustu iz bolnice te Glasgowskom
ljestvicom ishoda (GOS) unutar jedne godine od otpusta iz bolnice.
Rezultati: Meningeom lubanjske osnovice dijagnosticiran je u 109 bolesnika. Medijan dobi
bio je 63,0 godine, a značajno je više bilo ispitanika ženskoga spola (72,5 %). Pokazatelji
ishoda, GOS i KPI, statistički su značajno povezani s dobi (p = 0,043; p = 0,047), stanjem
svijesti bolesnika (p = 0,010; p < 0,001) i opsežnosti kirurškog uklanjanja tumora (p = 0,032;
p < 0,001). Nije bilo statistički značajne povezanosti spola, lokalizacije tumora,
patohistološkog stupnja tumora i poslijeoperacijskih komplikacija s ishodom liječenja.
Zaključak: Bolesnici starije životne dobi imaju lošiji ishod liječenja. Spol bolesnika ne utječe
na ishod liječenja. Bolesnici s očuvanim ili manje narušenim stanjem svijesti imaju bolji ishod
liječenja. Lokalizacija tumora bitno ne utječe na ishod liječenja. Bolesnici kojima je tumor
uklonjen u cijelosti imaju bolji ishod liječenja. Patohistološki stupanj i poslijeoperacijske
komplikacije ne utječu na ishod liječenja.Objectives: To examine whether is a correlation between patient age and gender, level of
consciousness, tumor localization, extent of surgical resection, pathohistological grade of
tumor, postoperative complications and outcome of skull base meningioma management.
Study Design: Cross-sectional study.
Patients and methods: The study included all patients with skull base meningioma treated at
the Department of Neurosurgery, Osijek Clinical Hospital Centre from 2000 to 2015. The
partients' data were obtained from medical records contained in the archive of the Department
of Neurosurgery, Osijek Clinical Hospital Centre. The outcome measure was obtained by
Karnofsky Performance Index (KPI) at discharge and Glasgow Outcome Scale (GOS) at one
year follow-up.
Results: Skull base meningioma was diagnosed in 109 patients. Median age was 63 years,
with a significantly female predominance (72.5 %). Outcome measure variables, GOS and
KPI, showed statistically significant correlation with patients' age (p = 0.043; p = 0.047), level
of consciousness at admission (p = 0.010; p < 0.001) and extent of surgical resection (p =
0.032; p < 0.001). There was no statistically significant correlation between the outcome and
certain variables such as gender, tumor localization and pathohistological grade, as well as
postoperative complications.
Conclusion: The outcome was correlated to patients’ age, but not their gender. Older patients
experienced a poorer outcome. The level of consciousness at admission was a strong outcome
predictor too. Patients whose consciousness was unaffected had a better chance of favorable
outcome. The outcome was not affected by tumor localization, pathohistological grade and/or
postoperative complications. However, it was much better in patients whose tumor was
completely resected
Quality of life assessment after surgical treatment of brain glioma
No full textCILJ: Ispitati postoji li utjecaj dobi, patohistološkog stupnja malignosti, opsega kirurške resekcije, prije operacijskog kliničkog stanja, adjuvantnog liječenja te komorbiditeta i navika (arterijska hipertenzija, povećana tjelesna masa i pušenje) na kvalitetu života nakon kirurškog liječenja glioma mozga. NACRT ISTRAŽIVANJA: Istraživanje je ustrojeno kao presječna studija. ISPITANICI I POSTUPCI: U istraživanje su uključeni bolesnici s dijagnosticiranim gliomom mozga u razdoblju od 2016. do 2020. koji su liječeni na Klinici za neurokirurgiju i Zavodu za onkologiju Kliničkog bolničkog centra Osijek. Podaci o ispitanicima preuzeti su iz medicinske dokumentacije pohranjene na Kliničkom zavodu za patologiju i Zavodu za onkologiju Kliničkog bolničkog centra Osijek. Kao instrument istraživanja koristili su se upitnici Europske organizacije za liječenje raka: EORTC QLQ-C30, temeljni upitnik kojim se procjenjuje kvaliteta života kod bolesnika s malignim tumorom, te EORTC QLQ-BN20, dodatni upitnik kojim se ispituje problematika specifična za tumor mozga. REZULTATI: Među ispitanicima najbolje je ocjenjeno kognitivno, a najlošije socijalno i poslovno funkcioniranje. Najučestaliji simptomi bili su slabost nogu, motorička disfunkcija, umor i pospanost, gubitak apetita te teškoće u komunikaciji. Kvaliteta života statistički je značajno bila povezana sa spolom, stupnjem malignosti, prije operacijskim kliničkim stanjem, adjuvantnim liječenjem te komorbiditetima, točnije arterijskom hipertenzijom i povećanom tjelesnom masom. Nije bilo značajne povezanosti dobi i opsega kirurške resekcije s kvalitetom života nakon kirurškog liječenja glioma mozga. ZAKLJUČAK: Različiti čimbenici utječu na kvalitetu života nakon kirurškog liječenja glioma mozga. Bolesnici s gliomom višeg stupnja malignosti, vrijednostima KPS nižima ili jednakima 70, te oni s prisutnim komorbiditetima (arterijska hipertenzija i povećana tjelena masa) imaju značajno lošiju kvalitetu života. Dob i opseg kirurške resekcije čimbenici su koji ne utječu na kvalitetu života. Ključne riječi: gliom; komorbiditeti; kvaliteta života;OBJECTIVES: To examine whether there is an impact of age, pathohistological degree of malignancy, extent of surgical resection, preoperative clinical condition, adjuvant treatment, comorbidities and habits (arterial hypertension, weight gain, and smoking) onto the quality of life after surgical treatment of brain glioma. STUDY DESIGN: The research was organized as a cross-sectional study. PARTICIPANTS AND METHODS: The study included patients diagnosed with brain glioma in the period from 2016 to 2020 who were treated at the Clinics of Neurosurgery and the Department of Oncology of the Clinical Hospital Center Osijek. The patients' data were taken from the medical documentation stored at the Clinical Department of Pathology and the Department of Oncology of the University Hospital Center Osijek. Two questionnaires of the European Organization for Cancer Treatment were used as a research instrument: EORTC QLQ-C30, a basic questionnaire assessing the quality of life in patients with malignant tumors, and the EORTC QLQ-BN20, an additional questionnaire examining problems specific to the brain tumor. RESULTS: Among the examinees, cognitive functioning was evaluated as the best, and social and role functioning as the worst. The most common symptoms were leg weakness, motor dysfunction, fatigue and drowsiness, loss of appetite and difficulty communicating. Statistically, the quality of life was significantly associated with gender, degree of malignancy, pre-operative clinical condition, adjuvant treatment and comorbidities, more specifically arterial hypertension and weight gain. There was no significant correlation between the age and extent of surgical resection with the quality of life after surgical treatment of brain glioma. CONCLUSION: Various factors affect the quality of life after surgical treatment of brain glioma. Patients with a higher grade glioma, KPS values lower than or equal to 70, and those with comorbidities (arterial hypertension and increased body weight) have a significantly worse quality of life. The age and extent of surgical resection are factors that do not affect the quality of life
The value of anterior cervical discecetomy and fusion with osseous allograft in the treatment of cervical spine degenerative disease
Get PDFCilj istraživanja. Cilj je ovoga istraživanja ispitati valjanost metode prednje cervikalne discektomije i fuzije koštanim alograftom u liječenju degeneracijske bolesti cervikalne kralješnice. Planirano je istražiti uspješnost ove metode u restituciji lordoze vratne kralješnice, smanjenju bolnoga sindroma i oporavku neurološkoga deficita. Također je planirano istražiti proces slijeganja koštanoga presatka, i njegov utjecaj na uspješnost liječenja. Nacrt studije. Istraživanje je ustrojeno kao retrospektivna studija ispitanika s degeneracijskom bolešću vratne kralješnice, operacijski liječenih metodom prednje cervikalne discektomije i fuzije koštanim alograftom. Ispitanici i metode. U istraživanje je uključeno 70 ispitanika. U svih je zabilježen prijeoperacijski neurološki status, intenzitet bolnoga sindroma kao i osnovni demografski i zdravstveni čimbenici. Neuroradiologijskom je obradom definirana vrsta kompresijske patologije i broj zahvaćenih razina. Izmjereni su kutovi zakrivljenosti cervikalne kralješnice prije i poslije operacije metodom stražnjih tangenti po Harrisonu, te procijenjena zakrivljenost kralješnice prije i poslije operacije Benzelovim kriterijima. Susljednim radiologijskim oslikavanjem praćen je nastanak solidne koštane fuzije, te proces slijeganja koštanih presadaka. Uspješnost je liječenja ocijenjena Odomovim kriterijima. Ispitan je utjecaj različitih demografskih, zdravstvenih i radiologijskih čimbenika na konačnu uspješnost liječenja. Rezultati. U gotovo 75 % ispitanika zabilježena je izvrsna i dobra uspješnost liječenja, ocijenjena Odomovim kriterijima. Razlika prijeoperacijskoga i poslijeoperacijskoga intenziteta bolnoga sindroma, kao i razlika u poboljšanju poslijeoperacijskoga neurološkoga statusa u odnosu na status prije operacije ocijenjene su statistički značajnima (p<0,01). Prosječna zakrivljenost cervikalne kralješnice mjerena kutom stražnjih tangenti po Harrisonu prije operacije iznosila je 10,3°, a poslije operacije 16,6°, a razlika je ocijenjena statistički značajnom (p<0,01). Utvrđena je korelacija između zakrivljenosti kralješnice procijenjenom Benzelovim kriterijima i mjerenom kutem stražnjih tangenti po Harrisonu. Srednja vrijednost slijeganja presatka iznosila je 7,12 %, a stupanj slijeganja nije utjecao na uspješnost liječenja. Prosječno vrijeme potrebno za postizanje solidne koštane fuzije iznosilo je 5,97 mjeseci. Zaključak. Operacijska metoda prednje cervikalne discektomije i fuzije koštanim alograftom valjana je metoda liječenja degeneracijske bolesti cervikalne kralješnice, kojom se postiže solidna koštana fuzija i poboljšanje parametara fiziološke zakrivljenosti vratne kralješnice, te zadovoljavajuća uspješnost liječenja. Slijeganje je presatka najizraženije tijekom prva tri mjeseca nakon operacije, u kaudalnih implantata višerazinskih konstrukcija, a stupanj slijeganja presatka ne utječe na uspješnost liječenja. Uspješnost liječenja ovisi o dinamici nastanka solidne koštane fuzije.Objectives. The aim of this study is validation of anterior cervical discectomy and fusion with osseous allograft as a treatment method for the management of cervical spine degenerative disease. It is intended to research its appliance in restitution of the cervical lordosis, pain reduction and neurological recovery. Furthermore, it is planned to research a process of graft subsidence, and its influence on the treatment outcome. Study design. The study was designed as a retrospective study of consecutive patients with degenerative disease of the cervical spine, treated by the method of anterior cervical discectomy and fusion by osseous allograft. Patients and Methods. The study included 70 patients. Preoperative neurological status, pain intensity and basic demographic data, as well as patient’s general health status were recorded. Neuroradiological workup was performed to assess compressive pathology and determine cervical levels involved. Posterior tangent angle of the cervical spine according to Harrison was measured before and after the surgery. Cervical spine configuration was further assessed using Benzel’s criteria. A formation of solid bone fusion and graft subsidence processes were noted on neuroradiological follow up. Tretment outcome was assessed using Odom’s criteria, and the possible influences of demographic, general health and radiological factors were researched
Characteristic features of convexity meningoma
Get PDFCilj istraživanja: Cilj je istraživanja ispitati postoji li povezanost između demografskih
čimbenika (dob i spol), stanja svijesti bolesnika, lokalizacije tumora, opsežnosti kirurškog
uklanjanja i patohistološkog stupnja tumora i konačnog ishoda liječenja meningeoma
lubanjskog svoda.
Nacrt studije: Provedeno je istraživanje presječnoga tipa.
Ispitanici i metode: U istraživanje su uključeni svi bolesnici s dijagnosticiranim
meningeomom lubanjskog svoda kirurški liječeni u Klinici za neurokirurgiju Kliničkog
bolničkog centra Osijek od 2000. do 2015. godine. Podatci za istraživanje preuzeti su iz
povijesti bolesti. Ishod liječenja ispitanika određen je Karnofskyjevim indeksom (KPI) i
Glasgowskom ljestvicom ishoda (GOS).
Rezultati: Od ukupno 134 ispitanika uključenih u istraživanje, 71,6 % bilo je ženskog spola, a
28,4 % muškog. Medijan dobi ispitanika iznosio je 64,0 godine. Pokazatelji ishoda liječenja,
KPI i GOS, statistički su značajno bili povezani s dobi (p < 0,001), stanjem svijesti ispitanika
(p < 0,001), Simpsonovim stupnjem opsežnosti kirurškog uklanjanja tumora (p < 0,001) i
lokalizacijom tumora (p = 0,049; p = 0,033). Statistički je značajna povezanost
patohistološkog stupnja tumora i GOS pokazatelja ishoda (p = 0,036).
Zaključak: Spol ispitanika ne utječe na ishod liječenja. Ispitanici mlađe životne dobi i
očuvanog stanja svijesti imaju u pravilu bolji ishod liječenja. Ispitanici s povoljno
lokaliziranim te potpuno uklonjenim tumorom imaju povoljniji ishod liječenja. Ispitanici s
patohistološki benignim tumorom imaju povoljniji ishod liječenja određen GOS
vrijednostima. Pouzdani pokazatelji uspješnosti kirurškog liječenja meningeoma lubanjskog
svoda su: dob ispitanika, stanje svijesti pri prijemu, lokalizacija i opsežnost kirurškog
uklanjanja tumora.Objectives: The aim of the research is to examine the correlation of the demographic factors
(age and gender), consciousness of patients at admission, tumor location, the extensiveness of
the surgical removal and histological grade of the tumor with the final outcome of the surgical
treatment of cerebral convexity meningioma.
Study Design: The research is a cross-sectional study.
Patients and methods: The research included all patients diagnosed with cranial vault
meningioma, treated at the Department of Neurosurgery, University Hospital Centre Osijek
from 2000 to 2015. Data were taken from patients’ medical history. The outcome of the
treatment was defined by the Karnofsky Performance Index (KPI) and Glasgow Outcome
Scale (GOS).
Results: There was a total of 134 patients included in the research, 71.6 % were female and
28.4 % male. The median age of patients was 64.0. Indicators of treatment outcomes, KPI and
GOS were significantly associated with age (p < 0.001), the admission consciousness
(p < 0.001), Simpson degree of extensiveness of the tumor surgical removal (p < 0.001) and
tumor location (p = 0.049; p = 0.033). There was a statistically significant correlation between
histological grade of the tumor and GOS indicators of outcome (p = 0.036).
Conclusion: Patients’ gender does not influence the outcome of the treatment. Younger
patients and those with preserved consciousness indicate generally better treatment outcome.
Patients with more conveniently localized tumor and those with the tumor completely
removed have more favorable treatment outcome. Patients with histologically benign tumors
have more favorable treatment outcome, determined by GOS values. The most valuable
predictors of the surgical management outcome of convexity meningioma are: patients’ age
and state of consciousness at admission, tumor localization, and extensiveness of the tumor
surgical resection
A Brief Review of the History of Global and Croatian Neurosurgery
Get PDFNeurokirurgija je istodobno jedna od najstarijih, ali i najmlađih medicinskih disciplina. Naime, arheološki nalazi potvrđuju opstojanje trepanacije lubanjske kosti već u mlađem kamenom dobu, dok je neurokirurgija kao zasebna disciplina utemeljena tek početkom 20. stoljeća. Opisi ozljeda glave i kralježnice, kao i trepanacije potječu već iz doba starog Egipta (papirus Edwina Smitha) te od antičkih liječnika, Hipokrata, aleksandrijske škole i Galena iz Pergama, koji je opisao vlastitu klasifikaciju lubanjskih prijeloma, dodatno usavršio trepanacijsku tehniku i znatno pridonio razumijevanju neuroanatomije i fiziologije. Nažalost, nakon toga prestalo je izučavanje središnjega živčanog sustava tijekom sljedećeg tisućljeća. Srednjovjekovni doprinos medicini i neurokirurgiji svodi se na djelovanje arapskih i perzijskih liječnika (Albukasis, Avicena), koji su prikupili, sačuvali i dodatno unaprijedili medicinsko znanje antičkog vremena, uključujući i neuroznanost. Dolaskom renesanse početkom 16. stoljeća započeo je znatan napredak anatomije, medicine i kirurgije te neuroznanosti kao preteče neurokirurgije. Kao rodonačelnici ovog doba posebice su se istaknuli Berengario da Carpi, Andreas Vesalius i Abroise Paré. Tijekom 19. stoljeća, u vrijeme znatnog napretka medicine i kirurgije, stvoreNeurosurgery is the oldest, but also the youngest medical discipline. Namely, archaeological findings confirm the existence of cranial bone trepanations in the Late Stone Age, while neurosurgery as a separate discipline was founded only at the beginning of the 20th century. Descriptions of head/spinal injuries, and trepanations, date back to ancient Egypt (Edwin Smith papyrus) and physicians like Hippocrates, the Alexandrian school, and Galen, who described his classification of cranial fractures, perfected trepanation and contributed to neuroanatomy and physiology. Unfortunately, with his disappearance, the study of the central nervous system ceased during the next millennium. Medieval contribution to neurosurgery is due to the work of Arab and Persian physicians (Albucasis, Avicenna), who collected, preserved, and improved the medical knowledge of ancient times, including neuroscience. With the arrival of the Renaissance in the early 16th century, significant advances in anatomy, medicine, surgery, and neuroscience began. Berengario da Carpi, Andreas Vesalius, and Ambroise Paré stood out as progenitors of this era. During the 19th century, at a time of progress in medicine and surgery, preconditions were created for more extensive and long-lasting neurosurgical procedures, while the era of modern neurosurgery began in the early 20th century with the pioneering activities of MacEwan, Horsley, Cushing, Elsberg, Dandy and many others. Further progress in neurosurgery was made through the use of an operating microscope, which from 1965 marked the era of modern microneurosurgery, founded by Yaşargil. The beginnings of neurosurgical activity in Croatia date back to the end of the 19th century when Theodor Wickerhauser published a record of the first craniotomy done in our country in 1886. In conclusion, modern neurosurgery as one of the most advanced medical professions is based on the achievements of its historical leaders, and on the cutting-edge diagnostic and surgical armamentaria, together with the superior neurosurgical service organization
Correction to: History of Spinal Surgery and Surgical Treatment of Spinal Intradural Tumors
No full text- …
