Keyhole tumor removal under local anesthesia
Küçük Resim Yok
Tarih
2006
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
maç: Hassas beyin alanlarında yerleşmişolan tumörlerin cerrahisi yüksek risk taşır. Biz yeni defisitlerin oluşumunu engellemek için bu lezyonları lokal anestezi ile çıkardık. Metod: lokal anestezi ile stereotaktik yönlendirme kullanarak anahtar deliği kraniotomi uyguladık. Hassas bölgeler fmri ve anatomik landmarklar kullanılarak seçildi. FMRI ile hassas beyin bölgesinden en uzak alan giriş noktası olarak seçildi. Devamlı nörolojik muayene ile kortikal subkortikal uyarı yapıldı. Postoperative MR kontrolleri 24-72 saat içinde yapıldı. Sonuçlar: %90 olgu total eksize edildi. 1 olgu intraserebral hemoraji nedeniyle eksitus oldu. 13 olguda kötüleşme oldu 3 olguda kötüleşme kalıcı oldu. Sonuç: stereotaktik yönlendirme ve lokal anestezi ile tumör rezeksiyonu güvenli ve etkin bir yöntemdir
Objective: Surgery of the lesions involving eloquent cortex carries the risk of neurological deficits. We performed resection of the lesions under local anesthesia in order to prevent new neurological deficits. Methods: We performed keyhole craniotomies under local anesthesia with stereotactic guidance. the eloquent areas were chosen using of anatomical landmarks and functional MRI studies. the most distant gyrus from the eloquent brain area where the tumor is most superficial was chosen for cortical incision. the resection of the lesions was performed with cortical-subcortical stimulation and under continuous neurological examination. Postoperative MRI controls were taken within 24-72 hours and 3 months after the operation. Results: in 92 patients functional MRI and stereotactic guidance were used for surgical planning. in 90% of the cases the lesions were totally removed. One patient died because of intracerebral hemorrhage, in 13 cases (14%) the surgery caused or worsened the neurological deficits. Three cases had permanent worsening. For the remaining cases the worsening was transient and resolved within a few days. Conclusion: Stereotactic guidance with the help of fMRI provides safe tumor resection under local anesthesia alone through keyhole craniotomy.
Objective: Surgery of the lesions involving eloquent cortex carries the risk of neurological deficits. We performed resection of the lesions under local anesthesia in order to prevent new neurological deficits. Methods: We performed keyhole craniotomies under local anesthesia with stereotactic guidance. the eloquent areas were chosen using of anatomical landmarks and functional MRI studies. the most distant gyrus from the eloquent brain area where the tumor is most superficial was chosen for cortical incision. the resection of the lesions was performed with cortical-subcortical stimulation and under continuous neurological examination. Postoperative MRI controls were taken within 24-72 hours and 3 months after the operation. Results: in 92 patients functional MRI and stereotactic guidance were used for surgical planning. in 90% of the cases the lesions were totally removed. One patient died because of intracerebral hemorrhage, in 13 cases (14%) the surgery caused or worsened the neurological deficits. Three cases had permanent worsening. For the remaining cases the worsening was transient and resolved within a few days. Conclusion: Stereotactic guidance with the help of fMRI provides safe tumor resection under local anesthesia alone through keyhole craniotomy.
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
2
