{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:19:32Z","timestamp":1761823172486},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,7]]},"abstract":"<jats:sec id=\"S1\">\n<jats:title><jats:italic>Object<\/jats:italic><\/jats:title>\n<jats:p>Hemangioblastomas in the lumbosacral region are rare, and the authors of prior reports have not defined the surgical management, histopathological features, or outcome in a group of patients after resection of these tumors. To identify features that will help guide the operative and clinical management of these lesions, the authors reviewed data obtained in a series of patients with von Hippel\u2014Lindau syndrome who underwent resection of lumbosacral nerve root hemangioblastomas.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"S2\">\n<jats:title><jats:italic>Methods<\/jats:italic><\/jats:title>\n<jats:p>Six consecutive patients (three men and three women; mean age at surgery 39 years [range 31\u201348 years]) who underwent operations for resection of lumbosacral nerve root hemangioblastomas were included in this study. The mean follow-up period was 23 months (range 6\u201345 months). Data derived from examination, hospital charts, operative findings, histopathological analysis, and magnetic resonance imaging were used to analyze surgical management and clinical outcome. The resected tumors were located in the lumbar (five cases) or sacral (one case) regions; the mean tumor size was 2728 mm<jats:sup>3<\/jats:sup> (range 80\u201315,022 mm<jats:sup>3<\/jats:sup>). Consistent with central nervous system (CNS) regional variation of space available to accommodate the neural compressive effect of the hemangioblastoma size, the mean tumor volume (2728 mm<jats:sup>3<\/jats:sup>) of these symptomatic lesions was much larger than that of symptomatic hemangioblastomas resected in the other regions of the CNS. Histopathological examination showed infiltration of the associated nerve root by the hemangioblastoma in each case. In five of the six patients complete resection was achieved, and in one patient intradural exploration of two hemangioblastomas was performed, but resection was not achieved because of motor root involvement. In all cases involving complete resections the patients experienced symptomatic improvement.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"S3\">\n<jats:title><jats:italic>Conclusions<\/jats:italic><\/jats:title>\n<jats:p>Lumbosacral nerve root hemangioblastomas can be safely removed in most patients with von Hippel\u2014Lindau syndrome. Generally, hemangioblastomas of the lumbosacral nerve roots should be resected when they become symptomatic. Because these neoplasms appear to originate from the nerve root, it is necessary to sacrifice the nerve root from which the hemangioblastoma originates to achieve complete resection.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/spi.2003.99.1.0064","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:57:33Z","timestamp":1241711853000},"page":"64-69","source":"Crossref","is-referenced-by-count":15,"title":["Surgical management of lumbosacral nerve root hemangioblastomas in von Hippel\u2014Lindau syndrome"],"prefix":"10.3171","volume":"99","author":[{"given":"Russell R.","family":"Lonser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Wait","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Butman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander O.","family":"Vortmeyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"McClellan M.","family":"Walther","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance S.","family":"Governale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward H.","family":"Oldfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg (Spine 1)","doi-asserted-by":"publisher","first-page":"160","DOI":"10.3171\/spi.1999.90.1.0160","article-title":"Hemangioblastoma of the L-5 nerve root. Case illustration.","volume":"90","author":"Chazono","year":"1999"},{"key":"b2","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1148\/radiology.194.3.7862955","article-title":"von Hippel-Lindau disease: genetic, clinical, and imaging features.","volume":"194","author":"Choyke","year":"1995"},{"key":"b3","series-title":"AJNR","first-page":"206","article-title":"MR findings in spinal hemangioblastoma: correlation with symptoms and with angiographic and surgical findings.","volume":"22","author":"Chu","year":"2001"},{"key":"b4","series-title":"Spine","first-page":"1248","article-title":"1990 AcroMed Award in basic science. Cauda equina anatomy. II: Extrathecal nerve roots and dorsal root ganglia.","volume":"15","author":"Cohen","year":"1990"},{"key":"b5","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1227\/00006123-198911000-00002","article-title":"Hemangioblastomas: clinical and histopathological factors correlated with recurrence.","volume":"25","author":"de la Monte","year":"1989"},{"key":"b6","series-title":"Surg Neurol","first-page":"223","article-title":"Subarachnoid hemorrhage due to intraspinal tumors.","volume":"9","author":"Djindjian","year":"1978"},{"key":"b7","series-title":"AJNR","first-page":"525","article-title":"Preoperative endovascular embolization of craniospinal hemangioblastomas.","volume":"17","author":"Eskridge","year":"1996"},{"key":"b8","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1212\/WNL.41.1.41","article-title":"Central nervous system involvement in Von Hippel-Lindau disease.","volume":"41","author":"Filling-Katz","year":"1991"},{"key":"b9","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"S2478","DOI":"10.1002\/(SICI)1097-0142(19991201)86:11+<2478::AID-CNCR4>3.0.CO;2-5","article-title":"Von Hippel-Lindau syndrome. A pleomorphic condition.","volume":"86","author":"Friedrich","year":"1999"},{"key":"b10","series-title":"Mod Pathol","first-page":"999","article-title":"Peripheral nerve hemangioblastoma.","volume":"11","author":"Giannini","year":"1998"},{"key":"b11","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1001\/jama.1992.03480090074030","article-title":"Screening for von Hippel-Lindau disease by DNA polymorphism analysis.","volume":"267","author":"Glenn","year":"1992"},{"key":"b12","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1007\/s00234-001-0749-8","article-title":"Myelopathy and sciatica induced by an extradural S1 root haemangioblastoma.","volume":"44","author":"Hermier","year":"2002"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.3171\/jns.1984.60.6.1279","article-title":"Von Hippel-Lindau syndrome with microscopic hemangioblastomas of the spinal nerve roots. Case report.","volume":"60","author":"Ismail","year":"1984"},{"key":"b14","series-title":"Neurosurgery","first-page":"702","article-title":"Intraoperative motor and sensory monitoring of the cauda equina.","volume":"34","author":"Kothbauer","year":"1994"},{"key":"b15","series-title":"Medicine (Balt)","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00005792-198901000-00001","article-title":"von Hippel-Lindau disease affecting 43 members of a single kindred.","volume":"68","author":"Lamiell","year":"1989"},{"key":"b16","series-title":"Science","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1126\/science.8493574","article-title":"Identification of the von Hippel-Lindau disease tumor suppressor gene.","volume":"260","author":"Latif","year":"1993"},{"key":"b17","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/BF00262842","article-title":"Electrical stimulation and multichannel EMG recording for identification of functional neural tissue during cauda equina surgery.","volume":"8","author":"Legatt","year":"1992"},{"key":"b18","series-title":"Lancet","article-title":"von Hippel-Lindau disease.","author":"Lonser"},{"key":"b19","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"106","DOI":"10.3171\/jns.2003.98.1.0106","article-title":"Surgical management of spinal cord hemangioblastomas in patients with von Hippel-Lindau disease.","volume":"98","author":"Lonser","year":"2003"},{"key":"b20","series-title":"J Comput Assist Tomogr","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1097\/00004728-199207000-00004","article-title":"Volume of pituitary macroadenomas: assessment by MRI.","volume":"16","author":"Lundin","year":"1992"},{"key":"b21","series-title":"J Med Genet","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1136\/jmg.33.2.120","article-title":"A genetic register for von Hippel-Lindau disease.","volume":"33","author":"Maddock","year":"1996"},{"key":"b22","series-title":"Medicine (Balt)","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1097\/00005792-199711000-00001","article-title":"von Hippel-Lindau disease.","volume":"76","author":"Maher","year":"1997"},{"key":"b23","series-title":"Clin Neurosurg","first-page":"204","article-title":"Anatomic principles of intradural spinal surgery.","volume":"41","author":"McCormick","year":"1994"},{"key":"b24","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1136\/jnnp.16.3.158","article-title":"The early diagnosis of tumours of the cauda equina.","volume":"16","author":"Milnes","year":"1953"},{"key":"b25","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1227\/00006123-198911000-00003","article-title":"Surgical management of hemangioblastoma of the spinal cord: a report of 18 cases.","volume":"25","author":"Murota","year":"1989"},{"key":"b26","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1136\/jnnp.55.10.898","article-title":"Central nervous system lesions in von Hippel-Lindau syndrome.","volume":"55","author":"Neumann","year":"1992"},{"key":"b27","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1097\/00007632-199912150-00012","article-title":"The application of intraoperative monitoring during surgery for spinal deformity.","volume":"24","author":"Owen","year":"1999"},{"key":"b28","series-title":"J Intern Med","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1046\/j.1365-2796.1998.00337.x","article-title":"Haemangioblastoma of the central nervous system in von Hippel-Lindau disease. French VHL Study Group.","volume":"243","author":"Richard","year":"1998"},{"key":"b29","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s101430050024","article-title":"Central nervous system hemangioblastomas, endolymphatic sac tumors, and von Hippel-Lindau disease.","volume":"23","author":"Richard","year":"2000"},{"key":"b30","series-title":"Zentralbl Neurochir","first-page":"78","article-title":"Intra-extradural hemangioblastoma of the cauda equina.","volume":"56","author":"Rohde","year":"1995"},{"key":"b31","series-title":"No Shinkei Geka","first-page":"695","article-title":"[Hemangioblastoma of the cauda equina\u2014a case report (author's transl).]","volume":"6","author":"Sasaki","year":"1978"},{"key":"b32","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1097\/00007632-199012000-00002","article-title":"Cauda equina anatomy. I: Intrathecal nerve root organization.","volume":"15","author":"Wall","year":"1990"},{"key":"b33","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3171\/jns.2003.98.1.0082","article-title":"The natural history of hemangioblastomas of the central nervous system in patients with von Hippel\u2014Lindau disease.","volume":"98","author":"Wanebo","year":"2003"},{"key":"b34","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"95","DOI":"10.3171\/jns.2003.98.1.0095","article-title":"Surgical management of brainstem hemangioblastomas in patients with von Hippel-Lindau disease.","volume":"98","author":"Weil","year":"2003"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/99\/1\/article-p64.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/99\/1\/article-p64.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/99\/1\/article-p64.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T20:36:47Z","timestamp":1681591007000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/99\/1\/article-p64.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,7]]},"references-count":34,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/spi.2003.99.1.0064","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2003,7]]}}}