Cognition and quality of life in patients after transcallosal microsurgery for midline tumors

The transcallosal route has been propagated as a safe approach to midline tumors. The present study was performed in order to elucidate the neurobehavioral late sequelae in patients after transcallosal microsurgery on near-midline tumors.

The present study was performed retrospectively with a delay between surgery and follow-up examination ranging from 2 to 36 months (mean 10.2 months).

The study was performed in the Department of Neurosurgery, University Hospital of the University of Technology (RWTH) Aachen, Germany.

A consecutive series of 18 patients treated for an intracranial lesion by transcallosal surgery was included into the study. The patients had to be not younger than 16 and not older than 67 years. The age mean was 38.9 years (range 16 to 65 years).

The surgical approach was performed along the falx cerebi under microneurosurgical conditions with direct use of the microscope after opening the dura.

Beyond neurological examinations, the patients were submitted to an extensive neuropsychological testing battery. Furthermore, quality of life was examined by means of a questionnaire.

Surgery was performed without persistent new neurological deficits. Cognitive deficits were found in short- and long-term memory, motor fine-coordination, reaction time, divided attention and fronto-cortical capacity. The quality of life was particularly impaired in the area of cognitive capacity in daily life. These findings could be related to the duration of preoperative symptoms and to the tumor location.

The deficits found cannot be explained by surgical damage to the corpus callosum itself. Rather, they seem to correspond to an extra-callosal pathology. Further studies with a prospective evaluation of larger patient samples are called for in the future.