Management of CNS Tumors (General Principles)

This chapter delves into the comprehensive management of CNS tumors, encompassing a wide array of strategies and considerations. It addresses the nuances of surgical approaches, radiation therapy, chemotherapy, and neurointerventional techniques. It also explores specific considerations in managing brain tumors during pregnancy; preoperative strategies including tumor embolization and functional mapping; intraoperative techniques such as 5-ALA intraoperative fluorescence and intraoperative MRI and CT; and postoperative complications and their management, including peritumoral edema, deep vein thrombosis (DVT), and postoperative worsening of neurological deficits. Treatment strategies for specific tumor types, including meningiomas, brain metastases, primary spinal tumors, and intradural craniocervical junction tumors, are also discussed. Furthermore, it provides insights into the outcomes and potential complications associated with radiation therapy, with a specific focus on radiation necrosis.