Nghe An General Friendship Hospital successfully treated two patients with large, complex brain tumors.

Patient Tran Thi Ngh. (76 years old, residing in Can Loc, Ha Tinh) was admitted to the Spinal Neurosurgery Department in a state of memory disorder, headache, vomiting, and weakness on the left side of the body. After an MRI scan, it was found that the patient had a large tumor (6.1x8.1x6.6cm) occupying the entire right frontal lobe and part of the left frontal lobe, with high blood vessel density in the tumor. Monitoring of meningioma compression caused dilation of the ventricles.

Because the tumor is large in size with vascular cysts and a rich vascular system, it is easy to have complications of massive bleeding during surgery, so the patient was consulted by an interdisciplinary team between Neurosurgery - Spine and the cerebrovascular intervention team of the Stroke Center.

Surgical team of Specialist Doctor 2 Le Quang Toan - Director of Stroke Center and doctors of the endovascular intervention unit (DSA) performed the procedure to block the blood vessels feeding the tumor for 2 hours.

One day later, Dr. Hoang Kim Tuan - Deputy Head of Spinal Neurosurgery Department, along with the microsurgery team, removed the tumor and decompressed the brain. The surgery lasted nearly 5 hours. The doctors separated the tumor, controlled the blood vessels that fed the tumor, and completely removed the tumor, preserving the nerve structures around the tumor and there were no complications during the surgery.

The second case is patient Nguyen Thi Th. (60 years old, residing in Anh Son, Nghe An) who was hospitalized due to headache, drowsiness, lethargy and weakness in the right limbs that gradually increased over the past month.

The patient was examined and diagnosed with a large meningioma (5.3x5.7x6.1cm) in the left hemisphere, severely compressing brain tissue, shifting the midline 22mm to the left, causing brain tissue herniation through the cerebral acanthalamus and cerebellar tentorium, threatening life.

The tumor has a high vascular density and many blood supply sources. The patient underwent endovascular intervention to embolize the blood vessels before surgery and had complete tumor resection surgery 1 day after embolization.

During the interdisciplinary consultation, the doctors agreed: these were cases of very large tumors, combined with cerebral edema causing severe brain compression, threatening brain herniation and death. Surgery was difficult and dangerous due to cerebral edema combined with high blood vessel density, which could easily cause bleeding during surgery and was difficult to stop.

At the same time, surgery also has the risk of damaging vital nerve structures around the tumor, with a high rate of complications and sequelae. The surgery needs to be performed under a surgical microscope, and requires appropriate coordination between neurosurgeons and anesthesiologists.

The third patient is Tran Van D. (11 years old, residing in Anh Son, Nghe An). He was admitted to the hospital because of back pain, kyphosis in the lumbar spine and progressive weakness in both legs. After taking X-rays, doctors discovered a mass of "large aneurysmal bone cysts in the L1 and L2 vertebrae".

After consultation, Specialist Doctor 2 Nguyen Canh Cuong - Deputy Head of the Department of Diagnostic Imaging and the vascular intervention team performed tumor-feeding vessel embolization. The patient then underwent surgery to completely remove the tumor and fix the spine with screws. After surgery, the patient recovered his mobility and was discharged in time to take the second semester exam with his peers.

Dr. Hoang Kim Tuan - Deputy Head of the Department of Spinal Neurosurgery said: “Brain tumors are a condition in which abnormal cells grow in the brain. Brain tumors include two types: benign brain tumors (non-cancerous) and malignant brain tumors (cancerous). Both types of brain tumors affect brain cells, causing brain damage and even endangering life. There are about 120 different types of brain tumors, most of which are tumors in brain tissue, in addition to tumors in the meninges, pituitary gland, cranial nerves... Any type of brain tumor can be dangerous for the patient. Brain tumors or benign brain tumors often progress slowly, and the symptoms of brain tumors in this case will also appear slowly and develop more insidiously. On the contrary, if the brain tumor develops rapidly, the patient will see more obvious symptoms in both frequency and severity.”

Currently, Nghe An General Hospital has 2 modern vascular intervention systems, has performed thousands of interventions on cerebral, coronary and carotid arteries, recently established a visceral vascular intervention team in the Department of Diagnostic Imaging with doctors and physicians trained at major vascular intervention centers, providing opportunities for patients with liver tumors, uterine tumors, cases of abdominal trauma, liver rupture, kidney rupture... to receive emergency care. The trend of multimodal treatment, combining many specialties is increasingly being widely applied in modern medicine, helping physicians thoroughly treat difficult diseases./.