Topographical risk factor analysis of new neurological deficits following precentral gyrus resection.

نویسندگان

  • Young-Hoon Kim
  • Chi Heon Kim
  • June Sic Kim
  • Sang Kun Lee
  • Jung Ho Han
  • Chae-Yong Kim
  • Chun Kee Chung
چکیده

BACKGROUND Precentral gyrus resections (PGRs) have been regarded as excessively hazardous interventions because of the risk of postoperative major neurological complications. OBJECTIVE To evaluate the neurological deterioration that follows PGRs and to assess the topographical risk factors associated with these morbidities. METHODS We reviewed 33 consecutive patients who experienced pharmacologically intractable epilepsy and underwent PGR with intraoperative cortical stimulation and mapping while under awake anesthesia. The etiological diagnoses were brain neoplasm in 26 patients (78.8%), cortical lesion in 4 (12.1%), and no lesion in 3 (9.1%). The mean follow-up period was 62.6 months (range, 12-146 months). All topographical analyses of the resected quadrant area were performed based on postoperative magnetic resonance images. RESULTS After PGR, 22 patients (66.7%) experienced neurological worsening, including 5 permanent deficits (15.2%) and 17 transient deficits (51.5%). Permanent deficits included 2 instances of weakness, 1 dysarthria, 1 dysesthesia, and 1 fine-movement disturbance of the hand. While the neurological risk for anterior lower quadrant PGR was 20.0% (1/5), the risk for posterior upper quadrant PGR was 100.0% (10/10). The anterior upper and posterior lower quadrant PGR caused neurological deteriorations in 60.0% (6/10) and 62.5% (5/8) of the patients, respectively. In a multivariate analysis, PGR of the posterior and upper quadrant sections were significant risk factors for post-PGR neurological deteriorations (P = .022 and 0.030, respectively). CONCLUSION The posterior upper quadrant of the precentral gyrus was vulnerable to post-resective neurological impairment.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Surgical resection of epileptogenic cortical dysplasia in precentral gyrus☆

We present the case of a patient with epilepsy arising from cortical dysplasia in his precentral gyrus. The lesion was resected based on the results of video-ECoG (electrocorticograph) monitoring and electrical cortical stimulation. The patient has been seizure-free for 1 year since operation, and no neurological deficits have been observed. We discuss possible mechanisms of cortical reorganiza...

متن کامل

Transient aphasias after left hemisphere resective surgery.

OBJECT Transient aphasias are often observed in the first few days after a patient has undergone resection in the language-dominant hemisphere. The aims of this prospective study were to characterize the incidence and nature of these aphasias and to determine whether there are relationships between location of the surgical site and deficits in specific language domains. METHODS One hundred te...

متن کامل

Complete tongue protrusion palsy due to subsequent cryptogenic cortical strokes.

To cite: Sebire D, Rigney L, Cordato DJ. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014207989 DESCRIPTION We describe a 76-year-old right-handed man who presented with acute onset of tongue protrusion palsy without additional neurological deficits or pseudobulbar stigmata. He had previously suffered five strokes. Six months prior to this presentation he had ...

متن کامل

Amusia following resection of a Heschl gyrus glioma. Case report.

The incidence and character of neurological deficits following resection of glial neoplasms localized to the Heschl gyrus are currently unknown. In this series, the authors report the clinical presentation, management, and postoperative course of three patients with right hemisphere Heschl gyrus gliomas, one of whom developed difficulty with music production and comprehension postoperatively. R...

متن کامل

Visuo-Spatial Imagery Impairment in Posterior Cortical Atrophy: A Cognitive and SPECT Study

This study investigated the cognitive profile and the cerebral perfusion pattern in a highly educated 70 year old gentleman with posterior cortical atrophy (PCA). Visuo-perceptual abilities, spatial memory, spatial representation and navigation, visuo-spatial mental imagery, semantic and episodic-autobiographical memory were assessed. Regional cerebral blood flow (rCBF) was imaged with SPECT. C...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Neurosurgery

دوره 76 6  شماره 

صفحات  -

تاریخ انتشار 2015