Awake Craniotomy for Resection of Left Temporal Cavernoma: 3-Dimensional Operative Video
| Autor: | Thomas Santarius, Ramez W. Kirollos, Rikin A. Trivedi, Krunal Patel, Karol P. Budohoski, Leonardo Desessards Olijnyk |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Sulcus 030218 nuclear medicine & medical imaging Surgery Temporal lobe Resection 03 medical and health sciences Awake craniotomy 0302 clinical medicine medicine.anatomical_structure Frontal lobe Cortex (anatomy) medicine Neurology (clinical) Awake surgery business 030217 neurology & neurosurgery Craniotomy |
| Zdroj: | Operative neurosurgery (Hagerstown, Md.). 17(3) |
| ISSN: | 2332-4260 |
| Popis: | Cavernomas presenting with seizures refractory to medical treatment may require surgical excision for seizure control. If superficial, they can be surgically accessible but can pose additional risks when located in or near eloquent cortex. In this 3D operative video we illustrate the technique for the resection of a left temporal cavernoma located near eloquent cortex for speech with awake surgery and cortical mapping to avoid a speech deficit postoperatively. Informed consent was obtained for this procedure. Navigation is used to localize the cavernoma following which a large craniotomy is performed exposing the temporal lobe, frontal lobe, and sylvian vein. Bipolar stimulation is used to localize speech with the patient awake until speech arrest occurs. The cavernoma is situated immediately inferior to the sulcus over which speech arrest occurs. The sulcus immediately above the cavernoma is opened and adjacent arteries are carefully preserved. The glial plane around the cavernoma is used to dissect the cavernoma from the surrounding cortex. Care is taken to remove the haemosiderin as this can act as a precipitant for ongoing seizures. In this case the patient had no neurological deficits following surgery and was seizure free. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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