Spinal cord astrocytomas of childhood.

The author has carried out gross total excision of an intramedullary spinal cord astrocytoma in 120 consecutive patients. This experience has led to the following conclusions: Holocord widening occurs in 60% of cases, and is diagnostic of a cystic astrocytoma. Despite the absence of a surgical plane of dissection, these neoplasms may be removed from "inside out" until a glia-tumor interface is recognized. Radical tumor excision is compatible with partial or total recovery of neurological function. The success of surgery is directly related to the preoperative neurological status of the patient. Paralysis or near paralysis was never improved, while mild to moderate preoperative neurological dysfunction often recovered. While this experience has established the efficacy of radical surgery, there is no information to suggest the duration of remission, or the likelihood of permanent cure. This will only become known at the time of retrospective analysis many years from now.