Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Bacterianas/prevención & control , Derivaciones del Líquido Cefalorraquídeo , Hidrocefalia/cirugía , Complicaciones Posoperatorias/prevención & control , Preescolar , Protocolos Clínicos , Femenino , Humanos , Cuidados Intraoperatorios , Masculino , Cuidados Posoperatorios , PremedicaciónRESUMEN
57 children with a cerebellar astrocytoma have been operated on between 1964-1982. Since 1977, CT Scan has led to safer and earlier diagnosis. CT Scan has documented three macroscopical types of cerebellar astrocytomas; a cystic form with a mural nodule enhanced and the wall of the cyst non enhanced, a cystic form with a nodule and the wall of the cyst enhanced, and a massive form. 6 patients were submitted to a ventricular-atrial shunt before direct surgery. All the patients underwent posterior fossa surgery in the sitting position. Removal of the tumor was macroscopically total in 48 patients. Removal is limited to the nodule for cystic form with the wall non enhanced. Removal is extended to the wall of the cyst when it is enhanced. In 9 patients, the CSF pathway was restored at the end of the procedure by cannulation of the Aqueduct with silastic tube. 3 patients died postoperatively (5.2%), 2 others later on (4 and 8 years). 3 patients had a recurrency. In 6 patients, radiation therapy was used after surgery.