tailieunhanh - Optic Nerve Disorders - part 5

Có đến 40% bệnh nhân có u thần kinh đệm chiasmal với khối lượng lớn exophytic phát triển hoặc trình bày với , 187 vị trí shunt não thất được khuyến khích. Mặc dù giống di căn của vị trí shunt phúc mạc sau đây hiếm khi xảy ra | 4. Compressive and Infiltrative Optic Neuropathies 109 Up to 40 of patients who have chiasmal gliomas with large exophytic masses develop or present with 187 Intraventricular shunt placement is recommended. Although metastatic seeding of the peritoneum following shunt placement rarely occurs it is not a 221 Ascites is a rare complication following placement of a ventriculoperitoneal shunt. In the study by West et al. 222 each of three children had a shunt for chiasmal glioma complicated by hydrocephalus and developed ascites without malignant cells. The ascites resolved after their shunt was revised to a ventriculoatrial system. Radiation Therapy. For chiasmatic-hypothalamic gliomas 80 of patients treated with radiation therapy at 4500 cGy to 5500 cGy experienced stabilization or tumor shrinkage as seen on radiologic The efficacy of radiation therapy on visual outcome and tumor progression is uncertain. In studies by Hoyt and Baghdassarian181 and Glaser et visual outcome was not correlated with radiation therapy in 20 patients. No difference was noted in the disease-free survival rate between the patients who had radiation therapy and those who did not. Even tumor shrinkage on CT scan was not correlated with clinical progression in 16 patients after radiation The cognitive and endocrinological side effects of radiation therapy occur most often in children less than 5 years of age when chiasmal gliomas are usually Other complications of radiation include malignancies in patients with NF-1 moyamoya disease and 226 In the study by Tao et al. 227 long-term follow-up of 29 children with irradiated chiasmal gliomas reported a 10-year survival of 89 . Tumor shrinkage was noted years after radiation. Vision improved in 24 worsened in 17 remained stable in 48 and was not evaluated in 10 . As a complication of radiation therapy cognitive impairment was found in 71 and .

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