ムラガキ ヨシヒロ   MURAGAKI Yoshihiro
  村垣 善浩
   所属   研究施設 研究施設
   職種   教授
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 [Functional mapping using subdural electrodes combined with monitoring during awake craniotomy enabled preservation of function and extensive resection of a glioma adjacent to the parietal lobe language sites: a case report]
掲載誌名 正式名:No shinkei geka. Neurological surgery
略  称:No Shinkei Geka
ISSNコード:03012603/03012603
掲載区分国内
巻・号・頁 43(1),63-68頁
著者・共著者 TAKEBAYASHI Kento†,SAITO Taiichi,NITTA Masayuki,TAMURA Manabu,MARUYAMA Takashi,MURAGAKI Yoshihiro,OKADA Yoshikazu
発行年月 2015/01
概要 INTRODUCTION: Surgical resection of gliomas located in the dominant parietal lobe is difficult because this lesion is surrounded by multiple functional areas. Although functional mapping during awake craniotomy is very useful for resection of gliomas adjacent to eloquent areas, the limited time available makes it difficult to sufficiently evaluate multiple functions, such as language, calculative ability, distinction of right and left sides, and finger recognition. Here, we report a case of anaplastic oligodendroglioma, which was successfully treated with a combination of functional mapping using subdural electrodes and monitoring under awake craniotomy for glioma. CASE PRESENTATION: A 32-year-old man presented with generalized seizure. Magnetic resonance imaging revealed a non-enhanced tumor in the left angular and supramarginal gyri. In addition, the tumor showed high accumulation on 11C-methionine positron emission tomography(PET)(tumor/normal brain tissue ratio=3.20). Preparatory mapping using subdural electrodes showed absence of brain functionon the tumor lesion. Surgical removal was performed using cortical mapping during awake craniotomy with an updated navigation system using intraoperative magnetic resonance imaging(MRI). The tumor was resected until aphasia was detected by functional monitoring, and the extent of tumor resection was 93%. The patient showed transient transcortical aphasia and Gerstmann's syndrome after surgery but eventually recovered. The pathological diagnosis was anaplastic oligodendroglioma, and the patient was administered chemo-radiotherapy. The patient has been progression free for more than 2 years. CONCLUSION: The combination of subdural electrode mapping and monitoring during awake craniotomy is useful in order to achieve preservation of function and extensive resection for gliomas in the dominant parietal lobe.
DOI 10.11477/mf.1436202948
文献番号 25557101
PMID 2015199028