Artículos de revistas
Strategies For Resection Of Lesions In The Motor Area: Preliminary Results In 42 Surgical Patients
Registro en:
Arquivos De Neuro-psiquiatria. , v. 64, n. 4, p. 963 - 970, 2006.
0004282X
10.1590/S0004-282X2006000600015
2-s2.0-33846329147
Autor
Sarmento S.A.
De Andrade E.M.F.
Tedeschi H.
Institución
Resumen
In recent years considerable technological advances have been made with the purpose of improving the surgical results in the treatment of eloquent lesions. The overall aim of this study is to evaluate the postoperative surgical outcome in 42 patients who underwent surgery to remove lesions around the motor cortex, in which preoperative planning by using neuroimaging exams, anatomical study, appropriate microsurgery technique and auxiliary methods such as cortical stimulation were performed. Twenty-two patients (52.3%) presented a normal motor function in the preoperative period. Of these, six developed transitory deficit. Twenty patients (47.6%) had a motor deficit preoperatively, nevertheless 90% of these improved postoperatively. Surgery in the motor area becomes safer and more effective with preoperative localization exams, anatomical knowledge and appropriate microsurgery technique. Cortical stimulation is important because it made possible to maximize the resection reducing the risk of a motor deficit. Stereotaxy method was useful in the location of subcortical lesions. 64 4 963 970 Berger, M.S., Ojemann, G.A., Intraoperative brain mapping techniques in neuro-oncology (1992) Stereotact Funct Neurosurg, 58, pp. 153-161 Ebeling, U., Schmid, U.D., Ying, H., Reulen, H.J., Safe surgery of lesions near the motor cortex using intra-operative mapping techniques: A report on 50 patients (1992) Acta Neurochir (Wien), 119, pp. 23-28 Cedzich, C., Taniguchi, M., Schafer, S., Schramm, J., Somatosensory evoked potential phase reversal and direct motor cortex stimulation during surgery in and around the central region (1996) Neurosurgery, 38, pp. 962-970 Yousry, T.A., Schmid, U.D., Jassoy, A.G., Topography of the cortical motor hand area: Prospective study with functional MR imaging and direct motor mapping at surgery (1995) Radiology, 195, pp. 23-29 Duffau, H., Recovery from complete hemiplegia following resection of a retrocentral metastasis: The prognostic value of intraoperative cortical stimulation (2001) J Neurosurg, 95, pp. 1050-1052 Sala, F., Lanteri, P., Brain surgery in motor areas: The invaluable assistance of intraoperative neurophysiological monitoring (2003) J Neurosurg Sci, 47, pp. 79-88 Romstock, J., Fahlbusch, R., Ganslandt, O., Nimsky, C., Strauss, C., Localisation of the sensorimotor cortex during surgery for brain tumours: Feasibility and waveform patterns of somatosensory evoked potentials (2002) J Neurol Neurosurg Psychiatry, 72, pp. 221-229 Wilkinson, I.D., Romanowski, C.A., Jellinek, D.A., Morris, J., Griffiths, P.D., Motor functional MRI for pre-operative and intraoperative neurosurgical guidance (2003) Br J Radiol, 76, pp. 98-103 Krainik, A., Lehericy, S., Duffau, H., Role of the supplementary motor a rea in motor deficit following medial frontal lobe surgery (2001) Neurology, 57, pp. 871-878 Ganslandt, O., Behari, S., Gralla, J., Fahlbusch, R., Nimsky, C., Neuronavigation: Concept, techniques and applications (2002) Neurol India, 50, pp. 244-255 Reithmeier, T., Krammer, M., Gumprecht, H., Gerstner, W., Lumenta, C.B., Neuronavigation combined with electrophysiological monitoring for surgery of lesions in eloquent brain areas in 42 cases: A retrospective comparison of the neurological outcome and the quality of resection with a control group with similar lesions (2003) Minim Invasive Neurosurg, 46, pp. 65-71 Coenen, V.A., Krings, T., Axer, H., Intraoperative three-dimensional visualization of the pyramidal tract in a neuronavigation system (PTV) reliably predicts true position of principal motor pathways (2003) Surg Neurol, 60, pp. 381-390 Jannin, P., Morandi, X., Fleig, O.J., Integration of sulcal and functional information for multimodal neuronavigation (2002) J Neurosurg, 96, pp. 713-723 Zimmermann, M., Seifert, V., Trantakis, C., Raabe, A., Open MRI-guided microsurgery of intracranial tumours in or near eloquent brain areas (2000) Acta Neurochir (Wien), 143, pp. 327-337 Ganslandt, O., Fahlbusch, R., Nimsky, C., Functional neuronavigation with magnetoencephalography: Outcome in 50 patients with lesions around the motor cortex (1999) J Neurosurg, 91, pp. 73-79 Reinges, M.H., Krings, T., Kranzlein, H., Functional and diffusion-weighted magnetic resonance imaging for visualization of the post-thalamic visual fiber tracts and the visual cortex (2004) Minim Invasive Neurosurg, 47, pp. 160-164 Yasargil, M.G., (1996) Microneurosurgery, IVB. , New York: Thieme Medical Publishers Paul, S.J.L., Broca and the first craniotomy based on cerebral localization (1991) J Neurosurg, 75, pp. 154-159 Rhoton Jr., A.L., The cerebrum (2002) Neurosurgery, 51 (SUPPL. 1), pp. S1-S51 Uematsu, S., Lesser, R.P., Gordon, B., Localization of sensorimotor cortex: The influence of Sherrington and Cushing on the modern concept (1992) Neurosurgery, 30, pp. 904-913 Boling, W., Olivier, A., Fabinyi, G., Historical contributions to the modern understanding of function in the central area (2002) Neurosurgery, 50, pp. 1296-1309 Silbergeld, D.L., Intraoperative transdural functional mapping. Technical note (1994) J Neurosurg, 80, pp. 756-758 Sisti, M.B., Solomon, R.A., Stein, B.M., Stereotactic craniotomy in the resection of small arteriovenous malformations (1991) J Neurosurg, 75, pp. 40-44 Ammirati, M., Vick, N., Liao, Y., Effect of the extent of surgical resection on survival and quality of life in patients with supratentorial glioblastomas and anaplastic astrocytomas (1987) Neurosurgery, 21, pp. 201-206 Berger, M.S., Kincaid, J., Ojemann, G.A., Lettich, E., Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors (1989) Neurosurgery, 25, pp. 786-792 Fontaine, D., Capelle, L., Duffau, H., Somatotopy of the supplementary motor area: Evidence from correlation of the extent of surgical resection with the clinical patterns of deficit (2002) Neurosurgery, 50, pp. 297-303 Schiffbauer, H., Ferrari, P., Rowley, H.A., Berger, M.S., Roberts, T.P., Functional activity within brain tumors: A magnetic source imaging study (2001) Neurosurgery, 49, pp. 1313-1320 Skirboll, S.S., Ojemann, G.A., Berger, M.S., Lettich, E., Winn, H.R., Functional cortex and subcortical white matter located within gliomas (1996) Neurosurgery, 38, pp. 678-684 Lee, H.K., Kim, J.S., Hwang, Y.M., Location of the primary motor cortex in schizencephaly (1999) Am J Neuroradiol, 20, pp. 163-166 Yoshiura, T., Hasuo, K., Mihara, F., Increased activity of the ipsilateral motor cortex during a hand motor task in patients with brain tumor and paresis (1997) Am J Neuroradiol, 18, pp. 865-869 Thiel, A., Herholz, K., Koyuncu, A., Plasticity of language networks in patients with brain tumors: A positron emission tomography activation study (2001) Ann Neurol, 50, pp. 620-629 Duffau, H., Capelle, L., Denvil, D., Functional recovery after surgical resection of low grade gliomas in eloquent brain: Hypothesis of brain compensation (2003) J Neurol Neurosurg Psychiatry, 74, pp. 901-907