Abstract
The efficacy of surgical decompression for supratentorial gliomas was studied retrospectively by CT and by postoperative course. We had 5 patients with glioblastomas 5 initial surgery and one second surgery for regrowth and 3 patients with astrocytomas.
Internal decompression was performed before irradiation in all patients except one who was given preoperative irradiation and deteriorated suddenly, and emergency operation of internal and external decompression was performed. Decompression was enough in 5 patients and they were discharged on foot after post-operative irradiation. Decompression was not enough in 4 patients. There were one postoperative death, 3 patients with postoperative CSF leakage through wound and menin-gitis. These patients could not have better living postoperatively. In conclusion, surgical decompression must be extensive enough to control intracranial pressure in the treatment of gliomas. Incomplete decompression may result in post-operative death or complication of CSF leakage and meningitis that might prevent the patient from having postoperative good life. This surgical decompression should precede irradiation because the patient of glioma with increased intracranial pressure may deteriorate rapidly during preoperative irradiation.
