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Abstract
In this thesis, 30 Patients with cerebral gliomas were admitted in the surosurgical department, Menoufiya University hospital where they were anaged and operated upon.
The aim of this work was to evaluate the different cerebral glial tumors, their rgical management and the outcome.
All patients were subjected to thorough clinical examination according to the Surological sheet applied in this study.
The mean age of our patients was 48.5 years. The vast majority of cases (24 ises, 80%) occurred in the age group between 40 to 70 years. In the current study,ere was a significant a relation between the patient’s age at presentation and’ognosis.
where, younger patients had belter prognosis.
Male patients were commonly affected than females. Male to female ratio was,3:1).
Headache and seizures were the most common presenting symptoms (76.7% id 56.7%) respectively. Other clinical presentations in decreasing order of iquency included, disturbed consciousness (40%), papilledema (40%), vomiting|0°/o), motor weakness (26.7%), language disorders (20%), sphincteric troubles)6.7%), cranial nerve affection (13.3%) and behavioral changes (13.3%).
Karnofsky performance score (KPS) was used to asses the patient’s erformance status. The majority of patients (17 cases, 56.7%) had KPS from 70% 100%, 11 patients (36,7%) had KPS from 40% to 60% and only 2 patients i,7%) had KPS from 0 to 30%. The mean KPS of studied cases was 70%. KPS id a remarkable relation to both the post-operative outcome and survival. Patients/ithKPS of 70% or more had better prognosis.
Radiological studies (CT scan and MR! with contrast) were performed for all ases included in the current study. Pre-operative MRI was helpful in establishing presumptive diagnosis for most cases of cerebral glioma.
Surgery was carried out for all cases included in this study aiming at removing smuch tumor as possible. Gross total excision was done in 8 cases (26.7%), ubtotal excision in 5 cases (16.7%), debulking in 14 cases (46.7%) and excision iopsy in 3 cases (10%).
The extent of surgical resection was one of the most important prognostic ictors of survival. Patients in whom gross total excision was done had better utcome and a significantly longer median survival than those in whom only vision biopsy or debulking was done.
Astrocytoma was the predominant pathological type of all gliomas. where 26 ases (86.7%) were astrocytomas, 3 cases (10%) were mixed gliomas.