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lüll High-grade intramedullary astrocytomas: 30 years experience at the Neurosurgery Department of the University of Rome "Sapienza" Raco A; Piccirilli M; Landi A; Lenzi J; Delfini R; Cantore GJ Neurosurg Spine 2010[Feb]; 12 (2): 144-53OBJECT: The goal in this study was to review a series of patients who underwent surgical removal of intramedullary high-grade gliomas, focusing on the functional outcome, recurrence rates, and technical problems continually debated in neurosurgical practice. METHODS: Between December 1976 and December 2006, 22 patients underwent removal of intramedullary high-grade gliomas. Lesions were located in the cervical spinal cord in 12 patients, and in the thoracic cord in 10. RESULTS: Histological examinations showed 10 Grade III astrocytomas and 12 glioblastomas. Only 2 of the 22 high-grade astrocytomas could be completely removed. The clinical postoperative status worsened in 14 patients (63.6%), was unchanged in 7 patients (31.8%), and there was 1 case of intraoperative death (4.5%). None of the 22 patients showed improvement in their neurological status postoperatively. In this series, excluding the 1 intraoperative death, all patients died of progression of the malignancy. CONCLUSIONS: Surgical treatment did not ameliorate the postoperative neurological status; instead, in the majority of cases, it prompted a worsening of the deficit. Radiotherapy and chemotherapy have a little influence on the length of survival. In this series, multimodality treatment of intramedullary high-grade astrocytomas has been shown to increase length of survival without improving the neurological status.|Adolescent[MESH]|Adult[MESH]|Astrocytoma/mortality/pathology/*surgery[MESH]|Cervical Vertebrae[MESH]|Child[MESH]|Female[MESH]|Humans[MESH]|Magnetic Resonance Imaging[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Recurrence, Local[MESH]|Neurosurgical Procedures/methods/mortality[MESH]|Rome[MESH]|Spinal Cord Neoplasms/mortality/pathology/*surgery[MESH]|Spinal Cord/pathology/surgery[MESH]|Thoracic Vertebrae[MESH]|Time Factors[MESH]|Treatment Outcome[MESH]|Young Adult[MESH] |