The prognosis of primary intracerebral tumours presenting with epilepsy: the outcome of medical and surgical management
| Autor: | D F Smith, Patrick M. Foy, D. Sandemann, Jane L. Hutton, I. R. Williams, M. D. M. Shaw, David Chadwick |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male Ependymoma medicine.medical_specialty Adolescent medicine.medical_treatment Oligodendroglioma Physical examination Astrocytoma Outcome (game theory) Epilepsy Postoperative Complications Text mining Confidence Intervals Humans Medicine Child Survival rate Aged Aged 80 and over Neurologic Examination medicine.diagnostic_test business.industry Proportional hazards model Supratentorial Neoplasms Glioma Middle Aged Prognosis medicine.disease Surgery Survival Rate Radiation therapy Psychiatry and Mental health Tomography x ray computed Female Radiology Neurology (clinical) Tomography X-Ray Computed business Research Article |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 54:915-920 |
| ISSN: | 0022-3050 |
| Popis: | It is not known whether conservative or early aggressive (resective surgery with or without radiotherapy) management is better for tumours presenting with epilepsy. The prognosis of 560 patients with a clinical and CT diagnosis of intrinsic supratentorial tumour was examined retrospectively. Epilepsy was the first symptom in 164 patients. Histological confirmation of diagnosis was available in 391 (70%) of cases. Median survival was 37 months in the group presenting with epilepsy and six months in those presenting with other symptoms (p less than 0.0001). Patients presenting with epilepsy were more likely to have a normal clinical examination, a non-enhancing low density lesion on CT scan and a low grade tumour. From Cox's stepwise proportional hazards model, significant independent variables adversely affecting prognosis were increasing age, focal neurological signs and enhancing CT lesions at diagnosis, non-resective surgery and male sex. Of those presenting with epilepsy 80 patients had surgical treatment within two months of CT diagnosis. The Cox's model failed to identify any beneficial effects for either early resective surgery or radiotherapy. In primary intracerebral tumours with presentations other than epilepsy, resective surgery and radiotherapy were amongst the important factors associated with prolonged survival. Primary intracerebral tumours presenting with epilepsy are relatively benign and their outcome appears to be chiefly determined by clinical factors. |
| Databáze: | OpenAIRE |
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