5-aminolevulinic acid-guided surgery for focal pediatric brainstem gliomas: A preliminary study

Surgical Neurology International
Jason Labuschagne

Abstract

There is a growing body of literature supporting the use of 5-aminolevulinic acid (5-ALA) in the pediatric population, however, its use is still considered "off label" in this setting. In this retrospective study, we report our experience using 5-ALA in pediatric patients with focal brainstem gliomas (BSGs). Patients younger than 16 years presenting with a newly diagnosed BSG that was focal in nature were considered suitable for treatment with 5-ALA-assisted surgery. Exclusion criteria included MRI features suggestive of a diffuse intrinsic pontine glioma. A single dose of 5-ALA was administered preoperatively. Intraoperative fluorescence was recorded as "solid," "vague," or "none." The effectiveness of the fluorescence was graded as "helpful" or "unhelpful." Eight patients underwent 5-ALA-assisted surgery. There were four tumors located in the pons, two midbrain tumors, and two cervicomedullary tumors. Histological analysis demonstrated three diffuse astrocytomas, three pilocytic astrocytomas, and two anaplastic astrocytomas. Solid fluorescence was found in three of the eight cases, vague fluorescence was found in two cases, and no fluorescence was found in three cases. Fluorescence was useful in 3 (37%) cases. No patients exp...Continue Reading

References

Jan 1, 1990·Pediatric Neurosurgery·A J BarkovichH J Hoffman
Oct 1, 1987·Cancer·S B LanskyD R Miller
Dec 1, 1986·Journal of Neurosurgery·A R StroinkR P Humphreys
Jan 1, 1986·Journal of Neurosurgery·F Epstein, E L McCleary
Jan 1, 1985·Acta neurochirurgica·C AlvisiM E Maccheroni
Jan 1, 1984·Journal of Neuro-oncology·T TomitaT P Naidich
Mar 1, 1993·Journal of Neurosurgery·F J Epstein, J P Farmer
May 1, 1996·Journal of Neuro-oncology·S Constantini, F Epstein
Jan 1, 1996·Pediatric Neurosurgery·A M KaplanR J Packer
Mar 1, 1997·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·J BehnkeE Markakis
Jan 19, 1999·Journal of Neuro-oncology·S E SchildE G Shaw
Dec 12, 2003·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·George I JalloDiana Freed
Oct 7, 2005·Journal of Neurosurgery·John KestleMarion L Walker
Mar 29, 2006·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·A SandriE Madon
May 9, 2006·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·C Mauffrey
Apr 6, 2007·Pediatric Neurosurgery·Pablo F RecinosGeorge I Jallo
Jun 20, 2008·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Charles Teo, Timothy L Siu
Jul 1, 2008·Journal of Neuro-oncology·Robert M HaywardKatherine E Warren
Apr 3, 2009·Journal of Neurosurgery. Pediatrics·James L FrazierGeorge I Jallo
Jun 13, 2009·Journal of Neurology, Neurosurgery, and Psychiatry·W RachingerF W Kreth
Dec 21, 2010·Journal of Neurosurgery·Rainer RitzMarcos S Tatagiba
Jul 5, 2011·Journal of Neurosurgery. Pediatrics·Todd C HankinsonMichael H Handler
Dec 23, 2011·Pediatric Blood & Cancer·Jacques GrillMark W Kieran
Apr 28, 2012·Clinical Neurology and Neurosurgery·Pasquale De BonisAnnunziato Mangiola
Jan 8, 2013·Journal of Neurosurgery. Pediatrics·Paul KlimoRobert A Sanford
Feb 5, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Hideki Ogiwara, Nobuhito Morota
Apr 23, 2013·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Luxin Yin, Liwei Zhang
May 28, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·M PreußU Nestler

❮ Previous
Next ❯

Methods Mentioned

BETA
surgical resection
light microscopy
biopsy
PCAs
confocal microscopy
biopsies

Software Mentioned

SPSS
SSPS

Related Concepts

Related Feeds

Astrocytes

Astrocytes are glial cells that support the blood-brain barrier, facilitate neurotransmission, provide nutrients to neurons, and help repair damaged nervous tissues. Here is the latest research.