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Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report
Although direct Gliadel(®) wafer implantation into the resection cavity has been shown to significantly improve survival in patients with high-grade gliomas, several complications have been associated with the implantations of Gliadel wafers, including brain edema, healing delay, cerebral spinal flu...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Neurosurgical Society
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364933/ https://www.ncbi.nlm.nih.gov/pubmed/28663961 http://dx.doi.org/10.2176/nmccrj.2014-0025 |
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author | Kuramitsu, Shunichiro Motomura, Kazuya Natsume, Atsushi Wakabayashi, Toshihiko |
author_facet | Kuramitsu, Shunichiro Motomura, Kazuya Natsume, Atsushi Wakabayashi, Toshihiko |
author_sort | Kuramitsu, Shunichiro |
collection | PubMed |
description | Although direct Gliadel(®) wafer implantation into the resection cavity has been shown to significantly improve survival in patients with high-grade gliomas, several complications have been associated with the implantations of Gliadel wafers, including brain edema, healing delay, cerebral spinal fluid leak, intracranial infections, and cyst formation. The brain edema that is associated with Gliadel wafer implantation might result in neurological deficits and significant morbidities and mortalities. In particular, it is not clear if they should be placed in the eloquent areas, such as language areas, motor areas, and areas related to cognitive function, even if these areas contain a remnant tumor. Here, we present a case of profound brain edema along the pyramidal tract due to Gliadel wafer implantation, which resulted in severe neurological deficits. This treatment represents a double-edged sword due to the possibility of severe symptomatic brain edema along the eloquent area, even though Gliadel wafers might be effective in controlling local tumor growth. We should keep in mind that Gliadel wafer placement in eloquent areas may result in severe disadvantages to patients and a loss of their quality of life. |
format | Online Article Text |
id | pubmed-5364933 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-53649332017-06-29 Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report Kuramitsu, Shunichiro Motomura, Kazuya Natsume, Atsushi Wakabayashi, Toshihiko NMC Case Rep J Case Report Although direct Gliadel(®) wafer implantation into the resection cavity has been shown to significantly improve survival in patients with high-grade gliomas, several complications have been associated with the implantations of Gliadel wafers, including brain edema, healing delay, cerebral spinal fluid leak, intracranial infections, and cyst formation. The brain edema that is associated with Gliadel wafer implantation might result in neurological deficits and significant morbidities and mortalities. In particular, it is not clear if they should be placed in the eloquent areas, such as language areas, motor areas, and areas related to cognitive function, even if these areas contain a remnant tumor. Here, we present a case of profound brain edema along the pyramidal tract due to Gliadel wafer implantation, which resulted in severe neurological deficits. This treatment represents a double-edged sword due to the possibility of severe symptomatic brain edema along the eloquent area, even though Gliadel wafers might be effective in controlling local tumor growth. We should keep in mind that Gliadel wafer placement in eloquent areas may result in severe disadvantages to patients and a loss of their quality of life. The Japan Neurosurgical Society 2014-10-08 /pmc/articles/PMC5364933/ /pubmed/28663961 http://dx.doi.org/10.2176/nmccrj.2014-0025 Text en © 2015 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Case Report Kuramitsu, Shunichiro Motomura, Kazuya Natsume, Atsushi Wakabayashi, Toshihiko Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report |
title | Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report |
title_full | Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report |
title_fullStr | Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report |
title_full_unstemmed | Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report |
title_short | Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the Eloquent Area: A Case Report |
title_sort | double-edged sword in the placement of carmustine (bcnu) wafers along the eloquent area: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364933/ https://www.ncbi.nlm.nih.gov/pubmed/28663961 http://dx.doi.org/10.2176/nmccrj.2014-0025 |
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