Navigated transcranial magnetic stimulation in patients with brain tumors adjacent to the motor area: preoperative planning and evaluaation of motor outcome
| Autor: | Pinto, Pedro Henrique da Costa Ferreira |
|---|---|
| Přispěvatelé: | Nigri, Flávio, Dáquer, Egas Caparelli Moniz de Aragão, Medeiros, Ana Heloisa de, Simões, Elington Lannes, Sousa, Marcus Andre Acioly de, Madeira, Eugenio Pacelle Queiroz |
| Jazyk: | portugalština |
| Rok vydání: | 2019 |
| Předmět: |
Cérebro Tumores Cirurgia Complicações e sequelas
Força muscular Motor mapping Cérebro Tumores Cirurgia Motor outcome Estimulação magnética cerebral Brain tumor Prognóstico motor Tumor cerebral Preoperative planning Navigated transcranial magnetic stimulation Mapeamento motor Mapeamento cerebral Estimulação magnética transcraniana navegada Planejamento pré-operatório CIENCIAS DA SAUDE::MEDICINA::CIRURGIA::NEUROCIRURGIA [CNPQ] |
| Zdroj: | Biblioteca Digital de Teses e Dissertações da UERJ Universidade do Estado do Rio de Janeiro (UERJ) instacron:UERJ |
| Popis: | Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T19:36:00Z No. of bitstreams: 1 TESE_FINAL_PUBLICADA_Pedro_Henrique_C_F_Pinto.pdf: 15318351 bytes, checksum: a0c0e895754bac081a0ee877f53c1dfb (MD5) Made available in DSpace on 2021-01-05T19:36:00Z (GMT). No. of bitstreams: 1 TESE_FINAL_PUBLICADA_Pedro_Henrique_C_F_Pinto.pdf: 15318351 bytes, checksum: a0c0e895754bac081a0ee877f53c1dfb (MD5) Previous issue date: 2019-07-11 Currently, navigated transcranial magnetic stimulation (nTMS) has several applications in the field of neurosurgery and neuro-oncology. In spite of the currently fast-paced development of nTMS in neurosurgical patients, it is a relatively recent method, with its applications and workflow still facing the process of adaptation, with only a few cases published in literature. With the purpose of expanding current knowledge about the role of nTMS in neurosurgery and neuro-oncology, patients with brain tumors adjacent to the motor area submitted to motor mapping with nTMS were studied. The effects of the preoperative mapping of the motor area by nTMS on the neurosurgeon's decision regarding surgical strategy and the use of nTMS as a tool for assessing motor outcome were analyzed. Fourteen patients who underwent neurosurgeon evaluation for preoperative planning with nTMS were studied. Of the 14 patients submitted to preoperative motor mapping, 9 were evaluated for the use of nTMS in the motor outcome.The preoperative planning of neurosurgeons who had access to motor mapping with nTMS differed from those who did not have this data avaliable. The preoperative planning of most neurosurgeons has changed in some way after knowledge of the motor area mapping with nTMS. In this study, the lower the distance between the hotspot and the tumor, the higher the power score found on patient s physical examination in the 1st and 3rd postoperative weeks. The presence of motor evoked potential at the 1st and 3rd postoperative weeks correlated with a better motor outcome in the contralateral upper limb. In conclusion, nTMS was useful as a tool in the preoperative planning and evaluation of the motor outcome of patients with brain tumors adjacent to the motor area. More studies are necessary to assess its real importance in patients with brain tumors near from motor area. A estimulação magnética transcraniana neuronavegada (EMTn) possui diversas aplicações no campo da neurocirurgia e da neuro-oncologia. Apesar do grande desenvolvimento da EMTn, trata-se de um método relativamente recente, especialmente em pacientes neurocirúrgicos, com um número limitado de casos publicados na literatura e que por esses motivos, a sua aplicação e funcionamento permanecem ainda em fase de adequação e evolução. Com a finalidade de acrescentar à literatura mais informações sobre o papel da EMTn, foram estudados pacientes com lesões expansivas cerebrais adjacentes à área motora, submetidos ao mapeamento motor com a EMTn. Foram analisados os efeitos do mapeamento pré-operatório da área motora por EMTn no processo de decisão do neurocirurgião quanto a sua estratégia cirúrgica e a utilização da EMTn como ferramenta de avaliação do prognóstico motor. Foram estudados 14 pacientes submetidos a avaliação dos neurocirurgiões quanto ao planejamento pré-operatório com a EMTn. Dos 14 pacientes submetidos ao mapeamento motor no pré-operatório, 9 foram avaliados quanto ao uso da EMTn no desfecho motor. O planejamento pré-operatório dos neurocirurgiões que tiveram acesso ao mapeamento motor com a EMTn foi diferente dos neurocirurgiões sem esses dados atingindo significância estatística (valor p |
| Databáze: | OpenAIRE |
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