CIVILICA We Respect the Science
(ناشر تخصصی کنفرانسهای کشور / شماره مجوز انتشارات از وزارت فرهنگ و ارشاد اسلامی: ۸۹۷۱)

گواهی نمایه سازی مقاله Initial Experience with Brain Mapping under Awake Craniotomy for Resection of Insular Gliomas of the Dominant Hemisphere

عنوان مقاله: Initial Experience with Brain Mapping under Awake Craniotomy for Resection of Insular Gliomas of the Dominant Hemisphere
شناسه (COI) مقاله: JR_IJN-2-2_002
منتشر شده در مجله جراحی مغز و اعصاب ایران در سال ۱۳۹۵
مشخصات نویسندگان مقاله:

Mohammad Shirani - MD, Assistant Professor of Neurosurgery, Sina Hospital, Brain and Spinal Cord Injury Research Center, Neuroscience Institute, TehranUniversity of Medical Sciences, Tehran, Iran
Maysam Alimohamadi - MD, PhD, Assistant Professor of Neurosurgery, Sina Hospital, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran,Iran
Reza Shariat Moharari - MD, Professor of Anesthesiology, Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Koorosh Darimi Yarandi - MD, Assistant Professor of Neurosurgery, Sina Hospital, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran

خلاصه مقاله:
Background & Importance: Insular lobe is located at the depth of sylvian fissure and is hidden by frontal, temporal and parietallobes in close vicinity of internal capsule and basal ganglia and adjacent to the speech centers in the dominant hemisphere. Thus,radical resection of insular gliomas can be even more difficult. Brain mapping techniques can be used to maximize the extent oftumor removal and minimize postoperative morbidities.Case Presentation: Patients with newly diagnosed gliomas of dominant insula were enrolled. The exclusion criteria were severecognitive and/or psychological disturbances, those with difficulty in communication, older than 65 years, severely obese patients,those with difficult airways for intubation and severe cardiovascular or respiratory diseases. All patients were evaluated by contrastenhanced brain MRI, functional brain MRI and diffusion tensor tractography of language and motor systems preoperatively. Allwere operated under awake craniotomy with the same anesthesiology protocol. Intraoperative monitoring included continuousmotor evoked potential, electromyography, electrocorticography, direct electrical stimulation of cortex and subcortical tracts. Theywere followed with serial neurological examination and imaging.Conclusion: Seven patients were enrolled including 3 man and 4 women with mean age of 44.4 years. 5 patients suffered fromlow grade and 2 from high grade glioma. The most common clinical presentation was seizure followed by speech disturbance,hemiparesis and memory loss. Extent of tumor resection ranged from 73 to 100%. No mortality or major postoperative neurologicaldeficit was encountered. Seizure control improved in 3/4 of patients with medical refractory epilepsy. One patient suffered frompermanent deterioration of speech after surgery.Brain mapping under awake craniotomy may be considered a safe method to maximize the extent of tumor resection, whilepreserving neurological function in patients with gliomas of the dominant insular lobe.

کلمات کلیدی:
Insular Glioma; Awake Craniotomy; Brain Mapping; Cortical Stimulation

صفحه اختصاصی مقاله و دریافت فایل کامل: https://www.civilica.com/Paper-JR_IJN-JR_IJN-2-2_002.html