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Titolo:
MAGNETOENCEPHALOGRAPHIC MAPPING - BASIS OF A NEW FUNCTIONAL RISK PROFILE IN THE SELECTION OF PATIENTS WITH CORTICAL BRAIN-LESIONS
Autore:
HUND M; REZAI AR; KRONBERG E; CAPPELL J; ZONENSHAYN M; RIBARY U; KELLY PJ; LINAS R;
Indirizzi:
NYU,SCH MED,DEPT PHYSIOL & NEUROSCI,550 1ST AVE NEW YORK NY 10016 NYU,SCH MED,DEPT PHYSIOL & NEUROSCI NEW YORK NY 10016 NYU,SCH MED,DEPT NEUROSURG NEW YORK NY 10016 MAX PLANCK INST COGNIT NEUROSCI LEIPZIG GERMANY
Titolo Testata:
Neurosurgery
fascicolo: 5, volume: 40, anno: 1997,
pagine: 936 - 942
SICI:
0148-396X(1997)40:5<936:MM-BOA>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
CENTRAL SULCUS; SOMATOSENSORY CORTEX; ORGANIZATION; RECORDINGS; SYSTEM; HUMANS; MEG; MRI;
Keywords:
FUNCTIONAL BRAIN MAPPING; MAGNETOENCEPHALOGRAPHY; RISK ANALYSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
M. Hund et al., "MAGNETOENCEPHALOGRAPHIC MAPPING - BASIS OF A NEW FUNCTIONAL RISK PROFILE IN THE SELECTION OF PATIENTS WITH CORTICAL BRAIN-LESIONS", Neurosurgery, 40(5), 1997, pp. 936-942

Abstract

OBJECTIVE: Surgical management of cortical lesions adjacent to or within the eloquent cerebral cortex requires a critical risk:benefit analysis of the procedure before intervention. This study introduced a measure of surgical risk, based on preoperative magnetoencephalographic (MEG) sensory and motor mapping, and tested its value in predicting surgical morbidity. METHODS: Forty patients (21 men and 19 women; mean age, 36.5 yr) with cortical lesions (12 arteriovenous malformations and 28 tumors) in the vicinity of the sensorimotor cortex were classified into high-, medium-, or low-risk categories by using the MEG-defined functional risk profile (FRP). This was based on the minimal distance between the lesion margin and the sensory and motor MEG sources, superimposed on a magnetic resonance imaging scan. Case management decisionswere based on the MEG mapping-derived FRP in combination with biopsy pathological findings, radiographic findings, and anatomic characteristics of the lesion. A recently developed protocol was used to transform MEG source locations into the stereotactic coordinate system. This procedure provided intraoperative access to MEG data in combination with stereotactic anatomic data displays routinely available on-line during surgery. RESULTS: It was determined that 11 patients diagnosed as having gliomas had high FRPs. The margin of the lesion was less than 4 mm from the nearest MEG dipole or involved the central sulcus directly. A nonoperative approach was used for six patients of this group, based on the MEG mapping-derived FRP. In the group with arteriovenous malformations, 6 of 12 patients with high or medium FRPs underwent nonoperative therapy. The remaining 28 patients, whose lesions showed satisfactory FRPs, underwent uneventful lesion resection, without postoperative neurological deficits. CONCLUSION: Our results suggest that MEG mapping-derived FRPs can serve as powerful tools for use in presurgical planning and during surgery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 02:07:35