Abstract:
BACKGROUND:Eloquent area surgery has become safer with the development of intraoperative neurophysiological monitoring and brain mapping techniques. However, the usefulness of intraoperative electric brain stimulation techniques applied to the management and surgical treatment of cavernous malformations in supratentorial eloquent areas is still not proven. With this study, we aim to describe our experience with the use of a tailored functional approach to treat cavernous malformations in supratentorial eloquent areas. METHODS:Twenty patients harboring cavernous malformations located in supratentorial eloquent areas were surgically treated. Individualized functional approach, using intraoperative brain mapping and/or neurophysiological monitoring, was utilized in each case. Eleven patients underwent surgery under awake conditions; meanwhile, nine patients underwent asleep surgery. RESULTS:Total resection was achieved in 19 cases (95%). In one patient, the resection was not possible due to high motor functional parenchyma surrounding the lesion tested by direct cortical stimulation. Ten (50%) patients presented transient neurological worsening. All of them achieved total neurological recovery within the first year of follow-up. Among the patients who presented seizures, 85% achieved seizure-free status during follow-up. No major complications occurred. CONCLUSIONS:Intraoperative electric brain stimulation techniques applied by a trained multidisciplinary team provide a valuable aid for the treatment of certain cavernous malformations. Our results suggest that tailored functional approach could help surgeons in adapting surgical strategies to prevent patients' permanent neurological damage.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Sanmillan JL,Lopez-Ojeda P,Fernández-Conejero I,Fernández-Coello A,Plans G,Ali-Ciurana Y,Gabarrós Adoi
10.1007/s00701-018-3644-3subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1963-1974issue
10eissn
0001-6268issn
0942-0940pii
10.1007/s00701-018-3644-3journal_volume
160pub_type
杂志文章abstract::An extensive and segmental spasm of the ophthalmic artery has been demonstrated angiographically a few hours after a car accident in a case with posttraumatic amaurosis. The possibility of a correlation between ophthalmic artery spasm and posttraumatic amaurosis has been discussed. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01886679
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abstract::A computer system, based on IBM PC, was designed for the cerebrospinal compensatory model identification. The intracranial pressure (ICP) signal, registered during the lumbo-lumbar infusion test is analyzed by means of the spectral analysis algorithm in order to measure precisely the pulse wave amplitude. The amplitud...
journal_title:Acta neurochirurgica
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abstract:OBJECTIVE:To introduce reliable and minimally invasive virtual surgical planning for superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using three-dimensional (3-D) rotational reconstruction digital subtraction angiography (DSA). METHODS:Twenty-eight consecutive patients (11 women and 17 m...
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journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
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