Demographic profile lateral and third ventricle tumors in tertiary hospital in kashmir valley

Abstrakt

BACKGROUND: Intraventricular lesions are uncommon, representing 1- 10 % of all CNS Tumours. Intraventricular tumours are ideal indications for microscopic neurosurgery, the general principle of removal of intraventricular tumour is interruption of blood supply to tumour and subsequent tumour debulking with the aim of  gross total excision  with minimum damage and the chosen corridor should optimize tumour access and protection of vulnerable structures.

OBJECTIVES:  to estimate gender, age, demography, histopathology, diversion requirement in the preoperative, intraoperative, or postoperative period, common presenting symptoms, and outcome.

METHODS: Prospective (Jan 2020 to December 2021) /retrospective (from Jan 2015 to Dec 2018) hospital-based observational study.

RESULTS: Out of a total of 38 patients, 23 were males and 15 were females, The mean age in our study was 26.77 years & the majority of our patients were in the age group of 0-9 years constituting 26.3%  followed by age group 10-19 years,20-29 years and 30-39 year group each constituting 15.8%. Majority of our patients belonged to district Baramulla (28.95), followed by Anantnag (21.1%), Budgam(18.4%), Kupwara (10.5%), Srinagar(7.9%), Shopian(5.3%), Ramban(2.6%) ,Kulgam(2.6%) & Ganderbal(2.6%), Most common presenting complaint was of raised ICP (42.11%) followed by visual symptoms(31.58%),seizure(10.53%), motor deficits(10.53%) and  memory deficits5.26%).Tumor were most commonly seen in lateral ventricle(n=19 followed by third ventricle(n-=8),Diversion procedure were used preoperatively in fifteen (n=15) patients, pre-operative temporary in one patient , intra op permanent in two patients(n=2), intraop temporary in five (n=5), post-op permanent in three (n=3)  & no CSF diversion was required in 12 patients.HPE revealed choroid plexus papiloma as the commonest tumor (n=6) followed by ependymoma (n=5) in lateral ventricle and craniopharyngioma(n=5) as the commonest tumor in the third ventricle. In-hospital death was seen in one case of lateral ventricle tumor, two mortalities at <6 months after discharge, one mortality at >6 months and 1 patient was lost in follow-up.in third ventricle tumors at >6 months two patients expired and one was lost to follow up. Pre-op Average MMSE was 16.23 and average post-op MMSE AWS 21.17.

CONCLUSION-The present study suggests that microsurgical approach  can be safely and effectively used to treat intraventricular tumors with aim of gross total excision with minimum damage  and good outcome.