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Follow-up care after treatment of intracranial tumors

Tumor follow-up

Meningioma

  • First MRI check-up should be at a consultation with the surgeon 3–6 months after the operation.
  • The surgeon then recommends a further follow-up plan, which should occur under the auspices of a neurological department in the patient's home county.
  • If the MRI at 3–6 months does not show signs of recurrence or residual tumor, an MRI at 1, 3, 5, 10, 15 and 20 years is usually recommended.
  • If the MRI at 3–6 months shows residual tumor, annual monitoring is recommended.
  • For tumor relapse or growth of residual tumor, the patient should be referred for another neurosurgical assessment for tumor resection or gamma knife treatment. 

Low-grade glioma (astrocytoma WHO grade I/II and oligodendroglioma)

  • First MRI check-up should be at a consultation with the surgeon 3–6 months after the operation.
  • The surgeon then recommends a further follow-up plan, which should occur under the auspices of a neurological department in the patient's home county.
  • If the MRI at 3–6 months does not show signs of recurrence or residual tumor, the next follow-up is recommended in 6 months with annual MRI monitoring thereafter.
  • If the MRI at 3–6 months shows relapse or residual tumor, an oncologist should be consulted. The neurosurgeon and oncologist will then decide  if futher surgical or oncological treatment should be given. If further observation is chosen in these cases, an individually adapted follow-up plan will be made.

Malignant gliomas, lymphomas, brain metastases and other malignant intracranial tumors.

  • The surgical treatment for these patients is only a part of the primary treatment.
  • All patients are referred by the neurosurgical department for radiation treatment and/or chemotherapy.
  • Follow-up will not take place in the neurosurgical department.
  • Approximately 4 weeks after discharge from the neurosurgical department, the patient is admitted for oncological treatment at a cancer clinic. 
  • After primary treatment (surgery, radiation and possibly chemotherapy) clinical follow-ups are recommended every 3–6  months under the auspices of an oncologist or a neurologist.
  • In the majority of cases, MRI is only of value for new symptoms suggesting tumor relapse.
  • For the majority of malignant intracranial tumors, only symptom-producing relapses will be assessed for further treatment. Unfortunately, the treatment possibilities for relapse are often limited. 

Adenoma of pituitary gland

  • All patients are referred for a 3 month follow-up at the endocrinological department.
  • At the 3 month follow-up, MRI is performed and the patient is evaluated for the need for hormone substitution. An eye examination is also performed. On the basis of the results, an individually adapted follow-up plan is produced.
  • Recurrence is not uncommon (10–20 %) and therefore it is necessary to have life-long, regular monitoring.

Rehabilitation

All rehabilitation should take place under the auspices of the neurological department in the patient's home county.

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