主要的临床发现及其在皮层-皮下区域的频率在清醒大脑映射中被测试为扩散的低度质瘤
Lucas Alverne F Albuquerque1, Leonardo José Monteiro de Macêdo Filho2, Cicera Jairlly Veras Rocha3
1Hospital Geral de Fortaleza, Department of Neurosurgery, Fortaleza, Ceará, Brazil; Universidade de Campinas, Department of Neurology, Campinas, São Paulo, Brazil.
概括
针对扩散性低度质瘤 (DLGG) 的清醒大脑手术绘制了关键大脑功能. 这项研究详细介绍了两个半球的手术内发现,确定了最大限度地去除瘤的关键功能区域,同时保持认知能力.
科学领域:
- 神经外科 神经外科
- 神经科学是一个神经科学.
- 在瘤学瘤学.
背景情况:
- 脑质瘤的清醒手术旨在最大限度地切除瘤并保持认知能力.
- 这种技术在瘤切除过程中提供了对大脑功能的独特见解.
- 了解功能局部化对于神经外科规划至关重要.
研究的目的:
- 详细介绍分散低度质瘤 (DLGG) 清醒手术期间的临床发现.
- 分析大脑半球两侧皮质和皮质下结构中功能发现的关系,频率和概率.
- 为了确定特定的大脑区域具有高的手术内功能反应.
主要方法:
- 对51个连续的DLGG病例的初始系列进行分析,这些病例经过清醒手术治疗.
- 在手术过程中对皮层和皮下功能反应的系统映射.
- 在左半球 (LH) 和右半球 (RH) 之间病例的分布.
主要成果:
- 在LH中,皮质映射揭示了频繁的运动反应 (33.3%),语音停顿 (16.9%) 和语义性偏听 (12.4%). 皮层下映图显示有语义性偏 (36.7%),缺血 (16.3%) 和语音坚持 (13.2%).
- 在RH中,皮质映射显示了运动反应 (38%),负运动反应 (17.3%) 和语音停止 (14.8%). 皮层下测绘发现了负的运动反应 (21.9%) 和正的运动反应 (17%).
- 确定的关键功能区域包括前中心,腹前运动皮质 (vPMC),后中心,下面前后筋 (IFOF),皮质脊髓管和体感纤维.
结论:
- 在清醒手术期间的手术内发现对于神经瘤手术至关重要.
- 特定的大脑区域,包括前中心环和IFOF,经常与功能反应有关.
- 右半球 (RH) 除了运动和感官功能之外,在语言中发挥着重要作用,突出显示了它在手术规划中的重要性.
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