Subtentorial astrocytomas in adults: treatment results

Objective. To study the clinical and morphological characteristics of subtentorial astrocyte, to prove the recommendations for therapeutic tactics in adults. Materials and methods. A retrospective analysis was performed on 232 patients with astrocytomas of subtentorial localization (Grade I-IV) undergone the treatment in Romodanov Neurosurgery Institute in the period between 1988 and 2016. Results. Overall, 20 (8.6%) patients had Grade I astrocytomas, 135(58,2%) – Grade II, 72 (31%) – Grade III and 5 (2.2%) – Grade IV. The main clinical manifestations included: headaches – 94%, coordination disturbances – 89%, nausea/vomiting – 47%. Morphological investigation has been performed. The basic clinical manifestations included headache (94%), disorders in static co-ordination – 89%, nausea and vomiting – 47%. All of the patients were operated. Ninety-seven (41.8%) patients underwent total resection, 51 (22%) – subtotal and 84 (36.2%) – partial. In the most of cases (142 patients), the tumor located in the hemisphere of cerebellum and in the vermis. A microscopic research demonstrated the variety of a histologic structure not only in the different cases, but also in the same tumor. Thirty-six (15.5%) patients were re-operated due to tumor. Conclusions. Regardless of removed tumors volume, generally the astrocytomas of fossa posterior have favourable prognosis. Nevertheless, they require further investigations, especially Higth Grade III-IV.