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International Journal of Neurology and Neurosurgery

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Thalamic gliomas: A clinical, radiological and pathological study of 39 cases

Suresh Nair N. , Suresh Nair N. , Girish Menon , Gopalakrishnan , C.V. , Mathew Abraham , Ravi Mohan Rao B.

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International Journal of Neurology and Neurosurgery 1(4):p 207-214, October - December 2009. | DOI:

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Abstract

Aim: To analyze the clinical profile, radiological and pathological findings and factors influencing outcome in thalamic gliomas. Materials and methods: A retrospective analysis of the case records of 39 patients with thalamic glioma, operated since Jan 2000 over a period of six years. Variables analysed include: age, sex, surgical procedures, and histology. Results: The study group included 24 males and 15 females. Raised intracranial pressure was the commonest mode of presentation in 29 (74%) patients followed by hemiparesis, visual deficit and dysphasia. Radiological features varied with the grade of the gliomas and four patients were found to have bilateral thalamic involvement. A radical decompression was attempted in 14 patients while the rest underwent a less radical surgery or biopsy of the tumor. 23 (59%) of the tumors were categorized as high-grade gliomas, and 16 (41%) as low grade. All patients received radiotherapy postoperatively. Of the 32 patients available for follow up, tumor progression/recurrence was observed in all of the high grade and five (12.8%) of the low-grade neoplasms. At the time of last follow up 69.6 % of the patients who underwent decompressive surgery had a good outcome compared to only 37.5 % of those who underwent biopsy. Conclusion: Age and sex did not influence outcome in our study. Patients with thalamic
gliomas who underwent radical cytoreductive surgery followed by adjuvant radiotherapy had a prolonged median survival with acceptable morbidity. High-grade tumors carry a dismal prognosis whatever be the radicality of tumor decompression.. 

Key words: Thalamus, gliomas, Magnetic resonance imaging

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