Postcentral gyrus resection of opercular gliomas is a risk factor for motor deficits caused by damaging the radiologically invisible arteries supplying the descending motor pathway
| Autor: | Ichiyo Shibahara, Ryuta Saito, Toshihiro Kumabe, Sumito Sato, Takuichiro Hide, Masayuki Kanamori, Yukihiko Sonoda, Teiji Tominaga |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology Adolescent Pyramidal Tracts Efferent Pathways Medullary Artery Neurosurgical Procedures 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Glioma Medicine Humans Postoperative Period Operculum (brain) Child Neuroradiology Aged Retrospective Studies Brain Mapping business.industry Postcentral gyrus Brain Neoplasms Precentral gyrus Anatomy Somatosensory Cortex Middle Aged medicine.disease Magnetic Resonance Imaging medicine.anatomical_structure Surgery Female Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery |
| Zdroj: | Acta neurochirurgica. 163(5) |
| ISSN: | 0942-0940 |
| Popis: | Postoperative motor deficits are among the worst morbidities of glioma surgery. We aim to investigate factors associated with postoperative motor deficits in patients with frontoparietal opercular gliomas. Thirty-four patients with frontoparietal opercular gliomas were retrospectively investigated. We examined the postoperative ischemic changes and locations obtained from MRI. Twenty-one patients (62%) presented postoperative ischemic changes. Postoperative MRI was featured with ischemic changes, all located at the subcortical area of the resection cavity. Six patients had postoperative motor deficits, whereas 28 patients did not. Compared to those without motor deficits, those with motor deficits were associated with old age, pre- and postcentral gyri resection, and postcentral gyrus resection (P = 0.023, 0,024, and 0.0060, respectively). A merged image of the resected cavity and T1-weighted brain atlas of the Montreal Neurological Institute showed that a critical area for postoperative motor deficits is the origin of the long insular arteries (LIAs) and the postcentral gyrus. Detail anatomical architecture created by the Human Connectome Project database and T2-weighted images showed that the subcortical area of the operculum of the postcentral gyrus is where the medullary arteries supply, and the motor pathways originated from the precentral gyrus run. We verified that the origin of the LIAs could damage the descending motor pathways during the resection of frontoparietal opercular gliomas. Also, we identified that motor pathways run the subcortical area of the operculum of the postcentral gyrus, indicating that the postcentral gyrus is an unrecognized area of damaging the descending motor pathways. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink